Endoscopic Management of Middle Ear Paragangliomas: A Case Series

Daniel E. Killeen, Cameron C. Wick, Jacob B. Hunter, Alejandro Rivas, George B. Wanna, João Flávio Nogueira, Joe Walter Kutz, Brandon Isaacson

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Objective: To investigate the efficacy and safety of endoscopic middle ear paraganglioma (glomus tympanicum) resection. Study Design: Case series with chart review. Setting: Multi-institutional tertiary university medical centers. Patients: Adult patients with middle ear paragangliomas treated via a transcanal endoscopic approach from 1/2012 to 11/2015. Intervention: All tumors were initially approached via a transcanal endoscopic technique. An operating microscope was used only if the tumor could not be adequately visualized or resected with endoscopic techniques alone. Main Outcome Measures: The main outcome was completeness of tumor resection via the endoscopic technique. Secondary measures were resolution of pulsatile tinnitus, audiometric outcomes, surgical duration, and surgical complications. Results: Endoscopic resection was attempted on 14 middle ear paragangliomas. Thirteen patients (93%) were women with a mean age of 61.6 years. The mean tumor size was 6.2 mm (SD, 3.3). Eleven cases (79%) had complete resection via an exclusive endoscopic approach. The mean surgical duration was 108.1 minutes (SD, 55.6). One case required use of an operating microscope via a transcanal route and two cases required postauricular incisions with mastoidectomy. There were no significant postoperative complications. Two patients (14%) had tympanic membrane perforations repaired intraoperatively without residual perforation on follow-up. All patients had normal postoperative facial nerve function. Pulsatile tinnitus resolved after surgery in all 13 patients who presented with this symptom preoperatively. The mean pure-tone average improved by 5.9 dB (SD, 4.6) after surgery. Conclusions: Endoscopic management of middle ear paraganglioma is safe, feasible, and effective.

Original languageEnglish
Pages (from-to)408-415
Number of pages8
JournalOtology and Neurotology
Issue number3
StatePublished - Mar 1 2017


  • Endoscopic
  • Glomus tympanicum
  • Middle ear tumor
  • Paraganglioma
  • Pulsatile tinnitus


Dive into the research topics of 'Endoscopic Management of Middle Ear Paragangliomas: A Case Series'. Together they form a unique fingerprint.

Cite this