Glomus vagale tumor: the significance of early vocal cord paralysis.

Glomus body tumors most frequently originate in the middle ear (tympanicum) or on the jugular bulb (jugulare). Tumors that arise from the vagal body account for less than 2.5% of these unique paraganglionic neoplasms. Otologic manifestations of tympanicum and jugulare tumors usually precede or accompany neurologic findings. In reviewing five cases of glomus vagale tumors, the initial symptom of voice change, caused by vocal cord paralysis, preceded the presenting symptoms of hearing loss and tinnitus by an average of 2.5 years. The concept of early cranial nerve involvement by glomus vagale tumors is supported in a literature review. The evaluation of "idiopathic" vocal cord paralysis must include radiographic inspection of the skull base, whereas an accurate, temporal account of presenting symptoms may help distinguish vagal body tumors from other vascular neoplasms of this region.