​Glomus Tumors (Glomus Tympanicum), (Glomus Jugulare)

Glomus tumors of the head and neck are slow-growing, benign tumors. There are two types: glomus tympanicum and glomus jugulare.

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What is a Glomus Tumor?

Glomus tumors — also known as paragangliomas — of the head and neck are benign (noncancerous) but locally invasive tumors that arise from glomus cells.

In the head and neck, glomus tumor tissue is found in the jugular bulb, middle ear, and carotid artery. Of these sites, tumors are most common in the jugular bulb, which is a region of the jugular vein positioned immediately below the middle ear. These glomus tumors may grow into the middle ear and brain.

Tumors originating in glomus cells of the middle ear are called glomus tympanicum tumors. Glomus tympanicum tumors are the most common vascular tumors of the middle ear.

Glomus tumors may also arise in deep neck (parapharyngeal) space along the course of the vagus nerve. These are called glomus vagale tumors.

Glomus tumors are highly vascular and usually solitary.

Because they are usually benign and slow-growing, mortality rates are low (less than 15 percent). However, their growth can cause significant damage to surrounding tissue and nerves.

Common symptoms of glomus tumors are hearing loss and facial palsies. 

At UPMC, the preferred treatment is a transmastoid surgical approach to remove the tumor.

In addition, Gamma Knife® radiosurgery may be used as the first treatment option or as an additional treatment after surgery.

Gamma Knife radiosurgery is a painless procedure that uses hundreds of highly focused radiation beams to target tumors and lesions within the brain, with no surgical incision.

Diagnosing Glomus Tumors

To diagnose a glomus tumor, your doctor will:

  • Ask you about your symptoms.
  • Perform a physical exam.
  • Order imaging and other diagnostic tests.

Glomus tumor symptoms

Symptoms of glomus tumors depend on their location: middle ear, jugular bulb, deep neck, or carotid artery.

Glomus tympanicum (middle ear)

  • Your ear may perceive the flow of blood as a pulsating sound or ringing.
  • Bleeding from the ear.
  • Hearing loss — the growing mass may interfere with sound transmission.

Glomus jugulare (jugular bulb)

Symptoms are similar to those of glomus tympanicum and may include:

  • Pulsations in the ear
  • Hearing loss
  • Ear pain
  • Bleeding from the ear

Compression of nearby cranial nerves may result in:

  • Facial weakness
  • Difficulty swallowing
  • Hoarseness
  • Shoulder drooping
  • Tongue weakness

In rare cases, these tumors may produce the hormone norepinephrine, which may cause:

  • Headaches
  • Anxiety
  • High blood pressure
  • Increased heart rate

Glomus vagale (deep neck space)

  • A mass in the parapharyngeal area along the course of the vagus nerve.
  • Facial palsies.
  • Hoarseness.

Carotid body tumors (carotid artery)

  • A painless mass in the neck that tends to cause no symptoms.
  • Larger tumors may compress the trachea and esophagus, resulting in hoarseness and difficulty swallowing.

Tests for diagnosing glomus tumors

Diagnostic tests may include:

  • Imaging studies — Glomus tumors of the head and neck are diagnosed primarily through MRI and CT scans. The specific locations of these tumors are usually sufficient for a diagnosis.
  • Angiograms — Because of their vascular nature, your doctor may also order an angiogram to confirm the diagnosis of glomus tumors.

In the middle ear, most glomus tympanicum tumors present with hearing loss and pulsatile tinnitus and are found during a physical exam, appearing as a reddish-blue mass behind the eardrum.

Glomus Tumor Treatments and Surgical Options

Transmastoid Surgical Approach

At UPMC, the preferred surgical approach for glomus tumors is the transmastoid approach (behind the ear), performed by a team of experts including a neurosurgeon and neurotologist.

Gamma Knife® Radiosurgery for Glomus Tumors

Gamma Knife radiosurgery is a painless procedure that uses hundreds of highly focused radiation beams to target tumors and lesions within the brain, with no surgical incision.

Gamma Knife radiosurgery is used to prevent further growth of the glomus tumor and maintain current neurological and hearing function.

The Gamma Knife may be used as the first treatment option, particularly in cases where the tumor is not causing mass effect, or as an adjuvant treatment after partial removal of glomus tumors.

As the nation's leading provider of Gamma Knife procedures, UPMC has treated more than 12,000 patients with tumors, vascular malformations, pain, and other functional problems.