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Due to the small tumor volume, radiosurgery would be an appropriate primary treatment option to control tumor growth and improve clinical outcomes.

They typically expand within the temporal bone via the path of least resistance, first eroding the jugular fossa, and then the posteroinferior petrous bone.

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Jugulotympanic tumors are organized by the Fisch Classification system which stratifies tumors based on location and extension to local structures. Type A designates tumors limited to the middle ear, for instance glomus tympanicum tumors.

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Type B designates tumors limited to the tympanomastoid area. Type C designates tumors invading the infralabyrinthine compartment of the temporal bone.

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Type D designates tumors with intracranial extension. The Fisch Classification aids in identifying the appropriate surgical approach.

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A small percentage of glomus tumors are functioning paragangliomas. Imaging studies, with the combination of CT and MRI with contrast, are the preferred diagnostic regimen. Angiography is supplementary and helps in treatment planning.

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It is also useful for pre-operative embolization. These modalities help identify the location, extent and neurovascular involvement of the tumor, which are all important in determining the preferred treatment method.

The ideal treatment method for a GJT is highly debated due to positioning near critical neurovascular structures.

Treatment options include observation, preoperative embolization, surgery, radiotherapy or radiosurgery. Surgical approaches consist of post auricular hypotympanotomy or transcanal tympanotomy for smaller tumors restricted to the middle ear, Fisch type A.


For larger tumors involving the tympanomastoid area, Fisch type B, atransmastoid resection is needed. Lastly, for tumors with either involvement of the carotid canal or intracranial extension, an extended facial recess with an infratemporal or transtemporal approach is necessary.

Although preoperative embolization is controversial, it is commonly used to decrease vascularity leading to less operative time and blood loss.

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  • While microsurgery is the definitive treatment, tumors in certain locations are considered high risk for surgical complications with the most common being cranial nerve deficits. Fayad et al.

    Other surgical morbidities include cerebrospinal fluid leakage, catastrophic bleeding, residual tumor and mortality.

    For supplements in which service is not feasible, federation and radiosurgery working safe and effective relation options with close morbidity.
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    Surgical resection is only recommended in medically operable patients with small tumors and minimal risk of neuropathy. A Celebration of Life Service will be held 6:00 P.