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A paraganglioma is a tumor that can originate from cells called paraganglia found in the middle ear. The temporal bone anatomy is shown, including the ear canal, ear drum, middle ear, and inner ear.
A brief anatomical review will allow a better understanding of the surrounding structures that can be involved with these tumors. The internal auditory canal is a bony canal from the inner ear to the posterior fossa where the cerebellum and brainstem are found.
Carotid body tumors arise from paraganglia located within the covering of the carotid artery in the neck. Learn how Metropolitan NeuroEar Group gives back to the community through numerous philanthropic efforts. If there is a problem in the outer or middle part of the ears, this affects the way sound is carried, or conducted, through to the inner ear and the rest of the auditory system. Hearing loss that results from damage to or disorders of the outer and middle ear is therefore referred to as conductive hearing loss.
The most common cause of conductive hearing loss, which mainly affects children, is otitis media. Effusion is the term for accumulation of fluid in a body cavity particularly within the cranial cavity, in the middle ear, around the lungs, around the heart, in the abdomen (peritoneal cavity) and in the joint spaces. Ask a Doctor Online Now!Fluid retention can also refer to edema which is commonly known as tissue swelling.
The excess fluid that collects in these cavities can be one of two types – transudates or exudates.
Transudates occur with a disturbance between the hydrostatic pressure or colloid osmotic pressure allowing fluid from the blood vessels to seep out or fluid from the tissue spaces to be pushed out into a cavity.
Infections at the site, other inflammatory diseases, trauma, radiation therapy,chemotherapy, certain medication, congestive heart failure, kidney failure and liver disease are some of the common causes among the various sites. An effusion in almost any cavity is largely asymptomatic until the fluid accumulation reaches a state where it causes distention of the affected area, pain or compression of the internal structures.
The compression of internal structures may not only cause pain, but also reduce blood supply to the area and even lead to tissue death.
Although an effusion is mainly exudative or transudative, it may be further classified by its composition which is also largely dependent on the cause of effusion. Serous effusion is similar to tissue fluid and the fluid of the blood (serum) with very little proteins.
Fibrinous effusion is where there is a large number of proteins, particularly fibrin and fibrinogen. Puruluent effusion (suppurative effusion) is the presence of pus within the accumulated fluid. A pleural effusion is when there is an abnormal accumulation of fluid within the pleural cavity. As with most effusions, a significant amount of fluid needs to accumulate in the pleural cavity before symptoms of the effusion becomes evident. Treatment depends on the underlying cause and the effusion itself may resolve if the condition is successfully treated. Sometimes when there is recurring pleural effusions, certain sclerosing agents are introduced into the pleural space to cause fibrosis of the pleura (pleural sclerosis). A pericardial effusion is the abnormal accumulation of fluid in the pleural space around the heart.
Inflammation of the pericardium (pericarditis) is one of the main reasons for a pericardial effusion. The brain essentially floats in a watery medium known as the cerebrospinal fluid (CSF) within the intracranial cavity. There are several disorders where there is an increase in intracranial pressure due to fluid accumulation. Hydrocephalus is an excessive accumulation of cerebrospinal fluid (CSF) within the intracranial cavity due to increased production or decreased drainage. Treating the underlying cause may halt the buildup of additional fluid and possibly even resolve spontaneously. The most common causes of a joint effusion are related to arthritis, particularly rheumatoid, psoriatic and septic arthritis. Accumulation of fluid within the joint may be asymptomatic until the fluid collection becomes excessive. Redness and warmth of the overlying skin are more likely to be associated with inflammatory causes. Joint deformity and nodules may be a consequence of the underlying disease that also causes an effusion. The treatment for a joint effusion depends on the cause but usually commences with medication. The middle ear is the space that lies beyond the tympanic membrane and further separated from the inner ear by the round and oval window. A middle ear effusion is the accumulation of fluid within the middle ear and is commonly referred to as fluid behind the eardrum. Middle ear effusion is associated with otitis media – inflammation of the middle ear. Children may present with other symptoms such as difficulty sleeping, constantly tugging on the ear, irritability, vomiting and diarrhea. Ask a Doctor Online Now!Most of the abdominal organs are contained within a membranous sac known as the peritoneum. The more common non-hepatic causes includes peritonitis, pancreatitis and congestive heart failure.
The signs and symptoms of ascites depends on the amount of fluid that is within the peritoneal cavity. As with an effusion anywhere in the body, the treatment is directed at the underlying cause. Ask a Doctor Online Now!Please note that any information or feedback on this website is not intended to replace a consultation with a health care professional and will not constitute a medical diagnosis. Other names commonly used for paraganglioma include chemodectoma, glomus tympanicum, and glomus jugulare tumors.
Benign tumors, in general, grow slowly and do not spread throughout the body, whereas malignant tumors have a faster growth pattern and can spread to other organs in the body.
Sanjay Prasad MD FACS is a board certified physician and surgeon with over twenty years of sub-specialty experience in Otology, Neurotology, advanced head and neck oncologic surgery, and cranial base surgery.


However, in cases where medical or surgical intervention is not appropriate, individuals with conductive hearing loss may be managed with hearing aids, including such special devices as bone-anchored hearing aids (BAHA) or bone conductor hearing aids. It is also referred to as fluid retention or water retention because most of the fluid is composed of water. Edema is the accumulation of excess fluid within the tissues whereas the term effusion indicates collection of fluid within a cavity of the body. Sometimes there is a little fluid within some of these cavities that is considered to be normal and is mainly for lubrication or proection. Normally the linings of these cavities secrete fluid for its specific purpose in carefully controlled quantities. Effusions are either transudates or exudates and may have varying quantities of pus or blood in some cases. However, this may not always be visibly evident if the outer wall is rigid like within the cranial or thoracic cavities. This can vary in intensity from a sensation of fullness and discomfort to dull or excruciating pain. This in turn has a wide variety of effects depending on the affected site but is mainly seen as dysfunction of the affected organs. This may be a combination of medication and drainage depending on the severity of the fluid accumulation.
These components are important for blood clotting but when present in the tissue spaces or body cavities it may cause the formation of scar tissue. At times, most of the fluid can be pus although it is more often mixed with exudative or transudative fluid. As with pus, sometimes blood itself can occupy the pleural space rather than being mixed with the existing effusion. More invasive procedures include video-assisted thoracoscopic surgery (VATS) or open thoracic surgery (thoracotomy) for removal of fibrous tissue in infections or causing fibrosis is recurrent effusions or with malignancies (pleural sclerosis). The visceral pericardium adheres to the outer surface of the heart (epicardium) while the parietal pericardium is attached to the fibrous pericardium which attaches to the chest wall. The quantity of accumulated fluid and the risk of a cardiac tamponade will also be taken into consideration. The CSF serves as a shock absorber ensuring that the brain does not strike against the skull when subjected to sudden or intense force. Most of this fluid is produced by the choroid plexus in the brain, drains out into the ventricles through formaina and into the subarachnoid space that surrounds the brain. Medication may be used to decrease CSF secretion or increase CSF resorption  in hydrocephalus or antibiotics to treat the infection in meningitis. In most cases this is due to the collection of synovial fluid but sometimes there may be pus or blood within the joint space. NSAIDs (non-steroidal anti-inflammatory drugs) is the drug of choice as it also helps with managing the pain.
Antibiotics are prescribed for bacterial infections and corticosteroids to reduce inflammation.
One layer, the visceral peritoneum, adheres to the abdominal organs while the other layer, the parietal peritoneum, is attached to the inner abdominal wall. Some of the therapeutic measures may include a sodium restricted diet, medication like diuretics to increase fluid excretion and therapeutic paracentesis to drain the fluid from the abdomen.
The tympanic eardrum is attached to one of three ossicles (bones) found in the middle ear called the malleus. The facial nerve is responsible for transmitting electrical impulses to the facial muscles, allowing motion of the face. Deep within the mastoid is a large vein called the sigmoid sinus that collects venous blood from that side of the brain. They generally do not involve the jugular bulb but can at times erode the bone over the jugular bulb.
With additional growth, venous blood from the brain also gradually begins to shift toward the other sigmoid sinus and jugular bulb. He is chief surgeon and founder of the private practice, Metropolitan NeuroEar Group, located in the metropolitan Washington D.C. The middle ear consists of the ear drum (the tympanum or tympanic membrane) and, beyond it, a cavity. There is sometimes confusion about these terms, particularly with certain organs like the lung. It is more likely to be present within double layered sacs like the pericardium (heart), pleura (lungs) and peritoneum (abdomen).
Any change in local conditions, however, will allow for the accumulation of transudative or exudative fluid. Other types of surgery may also be indicated depending on the site, cause and degree of tissue damage. Medication such as diuretics may help rid the body of excess fluid in conditions such as congestive heart failure. The space between the visceral and parietal pericardium is known as the pericardial space or cavity. If there is an excessive collection of fluid, it may compress the heart and this is known as a cardiac tamponade. Medication may include NSAIDs to reduce the inflammation, antibiotics to treat bacterial infections and diuretics to increase water excretion in congestive heart failure. From here it flows into the arachnoid villa and then into several venous sinuses which drain into the venous circulation.
There is small space between the two opposing surfaces known as the joint space or intra-articular space. The excess fluid hampers the normal joint movement due to the increased intra-articular pressure as a result of joint swelling. Corticosteroids may be be used in more severe and persistent cases and can be injected into the joint space (intra-articular injections). Most mucus within the middle ear can drain out through this tube into the back of the throat and air is able to enter and equalize the pressure with that of the outer ear.
It usually accompanies otitis media and is more correctly known as otitis media with middle ear effusion.
Normally this fluid would drain out through the eustachian tube but there is almost always some dysfunction of the tube.
A very small amount of fluid, the peritoneal fluid, exists in the space between these two layers (peritoneal space or cavity).


Ascites is commonly referred to as fluid retention in the abdomen but most cases of abdominal distention, particularly in instances like intermenstrual bloating, is not due to fluid accumulation. Ascites is graded to determine the severity based on the symptoms that are present – grade 1 has little or very mild symptoms, grade 2 is moderate ascites with some of the symptoms and grade 3 is for massive ascites with severe symptoms. In very rare circumstances, these tumors can behave like malignant lesions and spread to lymph nodes in the neck. Vibrations of the malleus bone are transmitted to another ossicle, the incus, which in turn transmits the vibrations to the smallest of the three ossicles, the stapes. This is the nerve that is responsible for our ability to raise our eyebrows, close our eyes, flare our nostrils and raise the corner of the mouth on that side. The symptoms that lead to this diagnosis include pulsatile tinnitus (ringing in the ears) that is heard with each heartbeat.
Symptoms of these tumors include pulsatile tinnitus (ringing in the ears) that is heard with each heartbeat. Although it is usually easily treatable, the incidence of otitis media is significantly higher among Indigenous children, for whom it represents a serious health and educational issue. This cavity is connected via a canal (the Eustachian tube) to the pharynx (the nasopharynx). The Eustachian tube permits the gas pressure in the middle ear cavity to adjust to external air pressure (so, as you're descending in a plane, it's the Eustachian tube that opens when your ears "open"). For example if there is fluid in the lung then it is known as pulmonary edema but fluid around the lung is known as a pleural effusion. In the inflammation process, the blood flow to the inflamed area increases and the blood vessels become more porous allowing large amounts of fluid from the blood, along with certain blood proteins, to exit the blood vessels and pass into the cavities.
When there is an accumulation of blood within the pleural space it is referred to as hemothorax and if lymphatic fluid then it is known as a chylothorax. Therapeutic thoracentesis, commonly known as a pleural tap, is a procedure for draining pleural fluid.
A small amount of fluid is normally present in this spaces and is known as pericardial fluid. The thin synovial membrane (synovium) covers the joint and also secrete synovial fluid into the joint space.
In conditions such as rheumatoid and psoriatic arthritis, drugs that suppress the immune system may be used to control the immune-mediated inflammatory reaction.
Normally there is very little fluid in the middle ear, serving only to moisturize the tissue lining its walls.
Surgical intervention may involve a myringotomy where a small opening is created  in the ear drum and the fluid is then drained. In fact men may have little or no fluid while women may find slight changes in the fluid levels during the menstrual cycle.
More than 1,000mL of fluid needs to accumulate in the peritoneal cavity before distention becomes evident. Parents who have concerns about their child's responsiveness to sound, language development, or behaviour should talk to their doctor. The middle ear cavity also contains a chain of 3 little bones (ossicles) that connect the ear drum to the internal ear. While it can happen in people of all ages, it mainly affects children.Middle Ear InfectionsA Close Look at the Ear.
The fluid in the cranial cavity, around the brain, known as the cerebrospinal fluid is present in much larger amounts normally since its function is to absorb shock and protect the brain. Sometimes the tiny blood vessels (microvasculature) is damaged and the vessels are partially ruptured thereby allowing for the free flow of whole blood.
When irritated, the fluid secretion from these linings increases significantly often exceeding the drainage ability.
Here there is about 1mL to 5mL of a serous fluid that serves as a lubricant which is known as pleural fluid. Other procedures are more invasive and may include open heart surgery to remove damaged tissue, drain excessive fluid and seal any sites of bleeding. This fluid serves as a shock absorber and also as lubricant for the smooth movement of the bones within the joint space.
Drugs such as xanthine oxidase inhibitors, probenicid or colchicine may be used to treat the disorder in uric acid metabolism as is seen in gout.
Pressure equalization tubes (PET), also known as ear grommets, may be inserted into the drum to allow for continuing drainage. The ossicles are named (not the Nina, the Pinta and the Santa Maria, but) the malleus, incus, and stapes. Next to the common cold, ear infections are the most commonly diagnosed childhood illness in the United States.
Pericardial sclerosis is where a sclerosing agent is introduced into the pleural space to cause fibrosis and bond the two pericardial layers if there is a recurring effusion. Arthrocentesis (joint aspiration) is the procedure for draining excess fluid from the joint space but is only a viable option for larger joints like the knee. The main causative factor for otitis media is an infection, either bacterial or viral in nature. Surgical removal of the adenoids (adenoidectomy) may also be useful and can help to restore eustachian tube function. In terms of function, the middle ear communicates with the pharynx, equilibrates with external pressure and transmits the ear drum vibrations to the inner ear. Sometimes a portion of the pericardium may have to be removed in instances of cancer or other causes of recurrent effusions. However, it is the eustachian tube dysfunction that causes the build up of the fluid (effusion). The cilia on the ends of hair cells within the inner ear are bent and an electrical signal is generated, traveling along the cochlear (hearing) nerve and then the brain. Intimately associated with the jugular bulb are several nerves that are involved with the swallowing mechanism. Another form of otitis media known as chronic suppurative otitis media may give rise to a purulent discharge (pus) but typically leads to a perforation of the ear drum thereby allowing the pus to drain out through the ear canal.
The inner ear is composed of the cochlea, which is responsible for hearing, and the semicircular canals that detect angular acceleration of the head.
This acceleration data, coupled with visual data and proprioceptive (position in space) data, determine our sense of balance.



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