“ This is the most common primary middle ear tumour in adults. It presents with pulsatile tinnitus and hearing loss and 30% have a VII pal...
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This is the most common primary middle ear tumour in adults. It presents with pulsatile tinnitus and hearing loss and 30% have a VII palsy. Examination demonstrates a pulsating cherry-red mass behind the tympanic membrane. Differentials include an aberrant carotid artery, persistent stapedial artery (look for an absent foramen spinosum) and jugular bulb variants.
• Densely enhancing mass at the cochlear promonitory.
• Arises from the wall of the middle ear.
• Does not erode the ossicles—it engulfs them.
INTERVENTION
• Most have a vascular supply from the ascending pharyngeal branch of the external carotid artery, which may be amenable to pre-operative embolisation.
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