Teaching NeuroImages: Collet-Sicard syndrome and hearing loss with glomus jugulotympanicum

A 56-year-old woman presented with headache, vomiting for 3 days, and right hearing loss, tinnitus, and dysphagia over 3 months. Examination showed decreased right palate elevation and atrophy of right sternocleidomastoid, trapezius, and tongue with rightward tongue deviation, indicating Collet-Sicard syndrome (involving cranial nerves IX–XII in jugular foramen and hypoglossal canal).¹ Hearing loss suggested auditory canal extension. Imaging showed a right skull base mass in keeping with glomus tumor (figures 1 and 2). Given surgical risks, radical radiotherapy was performed, arresting tumor growth. Glomus jugulare tumors, hypervascular paragangliomas, are the most common tumors in the jugular foramen and can extend into the middle ear (jugulotympanicum).²

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