Objectives: To illustrate the diagnostic value of progressive unilateral hearing loss, pulsatile tinnitus, and a vascular retrotympanic mass in recognizing an advanced jugular paraganglioma after an initial diagnosis of chronic Eustachian tube dysfunction.
Methods: We retrospectively describe the clinical, audiological, and computed tomographic findings of a 53-year-old woman evaluated at Windhoek Central Hospital in 2010 and interpret the historical case in the context of contemporary temporal-bone paraganglioma literature.
Results: The patient had approximately 3 years of progressive left hearing loss and intermittent ipsilateral pulsatile tinnitus. Otoscopy demonstrated a reddish vascular retrotympanic mass. Audiometry showed left mixed hearing loss, and tympanometry showed a type B tracing. Contrast-enhanced CT/CT angiography demonstrated a hypervascular mass centered at the left jugular bulb/foramen with irregular skull-base erosion, superior extension toward the hypotympanum and middle ear, jugulosigmoid involvement, close relationship to the carotid canal, deep skull-base extension, and probable intracranial involvement. Referral to a tertiary skull-base center was recommended.
Conclusions: A vascular retrotympanic mass associated with unilateral hearing loss and pulsatile tinnitus should prompt imaging for temporal-bone paraganglioma. Advanced tympanojugular lesions require careful definition of skull-base and neurovascular extension and multidisciplinary management.
This case is particularly noteworthy because it involves a female engineer who was initially essentially asymptomatic, presenting only with symptoms suggestive of Eustachian tube dysfunction. The underlying diagnosis was therefore initially missed. Several years later, while working in Africa, she was reevaluated for persistent and progressive otologic symptoms, leading to the identification of an advanced jugular paraganglioma. The case highlights how these generally slow-growing tumors may present with subtle and nonspecific otologic symptoms in their early stages, potentially delaying diagnosis until substantial skull-base extension has occurred.
- Quote paper
- Manuel Suárez (Author), 2026, Delayed Diagnosis of an Advanced Jugular Paraganglioma Mimicking Chronic Eustachian Tube Dysfunction. A Case Report, Munich, GRIN Verlag, https://www.grin.com/document/1768160
