NONCHROMAFFIN PARAGANGLIOMA OF THE MIDDLE EAR (GLOMUS JUGULARE TUMOR)

Abstract

THE PURPOSE of this paper is to report two new cases of nonchromaffin paraganglioma of the middle ear and to present a review of the medical literature and a résumé of the newer concepts of the pathogenesis of this tumor. REVIEW OF THE LITERATURE In 1941, Guild¹described a paraganglionic structure in the adventitia of the dome of the jugular bulb and along the ramus tympanicus of the glossopharyngeal nerve, resembling morphologically the carotid body, which he called the glomus jugulare. Watzka²recognized two types of paraganglions: (1) chromaffin, epinephrine-producing paraganglionic tissue and (2) nonchromaffin, nonepinephrine-producing paraganglionic tissue, the latter type associated with fibers of cranial nerves. In this second group he lists the carotid body, aortic bodies and "cells and cell groups found in the trunks of the glossopharyngeal and vagus nerves." The so-called glomus jugulare of Guild is one of the more recently described nonchromaffin paraganglions,