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Clinical Note |

Progressive Facial Paralysis Secondary to a Rare Temporal Bone Tumor Glomus Faciale

Noah P. Parker, MD; Tina C. Huang, MD
Arch Otolaryngol Head Neck Surg. 2011;137(7):712-715. doi:10.1001/archoto.2011.117.
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Paragangliomas are slow-growing benign neoplasms arising from foci of neural crest–derived chemoreceptor tissue, paraganglia. Paragangliomas are most often discovered based on mass effect on nearby structures and are rarely functional outside of the adrenal gland. In the head and neck, paraganglia most commonly reside at the carotid bifurcation, the inferior ganglion region or cervical portion of the vagus nerve, the jugular bulb, and the middle ear cavity; thus, most are discovered in these locations.1 In the skull base, paraganglia in the area of the jugular bulb and along the cochlear promontory make glomus tympanicum and glomus jugulare the most frequently encountered paragangliomas. Although these 2 tumors are relatively common in the temporal bone, a primary paraganglioma of the fallopian canal, or glomus faciale, is rare. In fact, to our knowledge, only 8 reports exist.18 We describe the presentation, workup, and treatment of the ninth report in the literature.

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Figure 1. T1-weighted, gadolinium-enhanced, fat-suppressed magnetic resonance image showing homogeneous enhancement of a left mastoid segment mass (white arrows). Axial (A) and coronal (B) views.

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Figure 2. Intraoperative view of a mass along the mastoid segment of the facial nerve just prior to biopsy. The short arrow depicts normal facial nerve superiorly. The long arrow points to the tumor inferiorly.

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Figure 3. Hematoxylin-eosin stain of paraganglioma showing the Zellballen pattern. Original magnification ×400 (A) and ×1000 (B) and immunohistochemical stains at original magnification ×1000 are positive for chromogranin A (C) and synaptophysin (D).




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