Introduction. Temporal bone paragangliomas (glomus tympanicum and glomus jugulare) are benign tumours by histological structure, but with growth, they are accompanied by a strong destructive potential to soft tissues and bone structures. Radical tumour removal is possible at an early stage. Without a timely diagnosis, the tumours are able to destroy vital organs, therefore, according to the clinical course, they are closely related to malignant tumours. Paragangliomas diagnosis and treatment in an early stage are important for further full patient rehabilitation.
Case report 1. According to magnetic resonance imaging results, a 28-year-old woman was diagnosed with a paraganglioma localized on the promontorium. Over the previous two months, the patient had periodic pulsatile tinnitus in the left ear during exercise, with full preservation of the hearing. After tumour radical removal by endaural approach, with complete preservation of the tympanic cavity anatomical structures and auditory function and dynamic observation over 5 years, recurrence of paraganglioma has not been detected.
Case report 2. A 65-year-old woman was treated for six years by a neurologist for pseudobulbar syndrome without positive dynamics. Initially, the main manifestations were difficulty swallowing with changes in taste, choking when eating liquid food, lack of sensitivity, and paresthesia in the left half of the pharynx. When performing tomography at that time, the radiologist did not notice the left ear’s initial stage of the paraganglioma. Only complaints about the appearance of a sensation of pulsation in the left ear and the constantly growing pulsatile tinnitus over the past month, against the background of significantly increased neurological symptoms, led to an ENT doctor. A glomus jugulare was diagnosed on magnetic resonance imaging.
Conclusions. To prevent possible errors in the diagnosis of paragangliomas, the physicians must carefully evaluate the minimal symptoms, referring the patients for imaging investigations.
Keywords: temporal bone paraganglioma, jugular foramen syndrome, pseudobulbar syndrome, ear spiral computed tomography, brain magnetic resonance imaging.
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Department of Clinical Pharmacology and Clinical Pharmacy, National University of Pharmacy, Kharkiv, Ukraine
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