Role of Otoendoscopy in the Management of Glomus Tympanicum

Background. Glomus Tympanicum is the commonest middle ear neoplasm. Total removal through conservative middle-ear surgery is the gold standard of treatment. Variable surgical techniques have been reported with modifications. Hypothesis. Using endoscopes improves diagnosis and surgical removal of glomus tympanicum. Study design. Prospective case series. Methods. Examination of ears with suspected glomus tumours was done by microscope and endoscope. CT scan was done to confirm the diagnosis and typing. Endoscopic assisted surgical excision was done; using the standard microscopic technique and adjunctively using 2.7 and 4mm 30o endoscopes, and angled fine instruments. Results. Eleven patients (11 ears) with different types of glomus tympanicum were diagnosed and treated. Endoscopes were superior to microscopes to detect smaller lesions behind tympanic membrane. Complete removal could be accomplished without performing a wide canaloplasty or canal wall down technique in 10/11 (91%). No evidence for recurrence was noted in the follow up period. Conclusion. Otoendoscopy aids diagnosis of glomus tumours at earlier stages, and ensures complete tumour removal from hidden areas and controlling the feeding vessel.