0:01

It's interesting because we said that the carotid

0:03

body tumors tend to favor the right side.

0:06

My inclination on glomus jugulare tumor is that

0:09

they occur more commonly on the left side.

0:12

And that was the case with this individual.

0:14

If we look at the skull base starting from above,

0:18

we come down and we are looking at the transverse sinus.

0:21

We're following the transverse sinus.

0:23

We're going from the transverse sinus to the

0:27

sigmoid sinus. And at the sigmoid sinus,

0:29

we see that there is soft tissue here associated with

0:33

erosion of the bone and enlargement of the jugular

0:37

foramen with this soft tissue mass.

0:41

So gross irregular erosion of the jugular foramen.

0:46

We see that, once again,

0:49

we have the normal jugular vein and

0:51

carotid artery on the right.

0:53

We have the normal internal carotid artery on the left,

1:00

but there is soft tissue growing into this jugular vein.

1:05

And this implies that the patient has a glomus jugulare.

1:11

And you notice that down lower,

1:13

the jugular vein returns to normal.

1:15

Why is that?

1:15

It's receiving lots of veins from the retromandibular

1:18

vein and the anterior jugular vein,

1:20

and the external jugular vein,

1:21

which is why it remains patent.

1:24

But in this case,

1:25

a nice example of the degree of the bone erosion

1:27

that may occur with the glomus jugulare.

1:31

Next, we want to look at the middle ear cavity.

1:34

So here is our middle ear cavity

1:35

with the middle ear ossicles.

1:37

We can look at this on the CT scan

1:39

with thinner section imaging.

1:42

And there is no soft tissue in the middle ear cavity

1:46

to suggest a glomus jugulotympanicum.

1:49

However, we do see that there is dehiscence at the jugular

1:54

foramen here. And if they were doing otoscopy,

1:59

they may see a retro tympanic red mass, secondary to the

2:04

growth of the glomus jugulare through

2:07

the posterior wall here.

2:09

So, another left-sided glomus jugulare

2:13

growing into the jugular vein and showing bone erosion

2:17

of the temporal bone,

2:19

but without a soft tissue mass in the middle ear cavity.