Transcanal Endoscopic Management of Gloms Tympanicum: A Multi Centric Case Series

By June 10, 2019

Fermi, Matteo1; Ferri, Gaetano1; Ebaied, Tamer Bayoumi1,2; Alicandri-Ciufelli, Matteo1; Bonali, Marco1; El-Dine, Mohamed Badr; Presutti, Livio 1
1 Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Modena, Modena, Italy;
2 Otolaryngology Head & Neck Unit and Neurotological Unit,Alexandria Main University Hospital, Alexandria, Egypt.

To describe multicentric surgical experience in exclusive endoscopic management of glomus tympanicum.

Study Design: Retrospective cohort multi-centric study
Setting: Two tertiary care centers
Patients: Patients that underwent endoscopic transcanal excision of glomus tympanicum
Intervention: Endoscopic transcanal tympanoplasty for glomus tympanicum

Main Outcome Measure(s): Gross total resection rate, Functional outcome (PTA AC, PTA BC, ABG, ABG closure), Intraoperative/Perioperative/Postoperative complications.

All the tumors were staged following the modified Fisch-Mattox scale, resulting in 36.7% A1 class, 33.3% A2 class and 30% B1 class. None of these cases required conversion to the microscope and gross total resection was obtained in 90%. Ossicular chain and chorda tympani were kept intact respectively in 83.3% and in 73.3%. None of the patients experienced perioperative complications and mean hospitalization time was 1.6 (+/- 0.8 SD) days. Only 1 patient (3.3%) had a persistent tympanic membrane perforation and required a myringoplasty. All the patients judged to have gross total resection were free from any residual or recurrence after follow-up of 23.7 (+/- 25.7 SD) months.

Middle ear paragangliomas with no mastoid involvement (Class A1 to B1) can be managed by means of a transcanal endoscopic approach. Low rate of post-operative complications, short hospitalization and high rate of gross total resection obtained through this approach, demonstrate that it is a safe and effective procedure.