In seven patients visited Kyushu University Hospital over a period of 3 years and 8 months the temporal bone was destructed around the jugular foramen. Their clinical manifestations and findings were examined and the importance of the diagnosis of these lesions was discussed. There were three males and four females, ranging in age from 27 to 61 years (average: 48) old. In addition to the usual physical examination, the neurological evaluation included pure tone audiometry, electronystagmography when there was a subjective feeling of imbalance, and video fluorogram of the pharynx for estimating the lower cranial nerves function. The extent and characteristics of the lesions were investigated using temporal and facio-cervical CT and MRI. Histological examinations were used to verify the diagnosis. In two cases a tumor extended into the external auditory canal, and specimens were taken after cutting the covering skin under local anesthesia. Deep masses were excised using a transmastoid approach under general anesthesia. The seven lesions consisted of three benign tumors, two primary malignant tumors, one metastatic tumor, and one cholesterol granuloma. Three of the seven cases were presented in detail. Although English literature reported a high incidence of glomus tumor, our series included only one. Although the clinical manifestations and imaging studies were useful for the differential diagnosis, pathohistological examination was necessary for the definitive diagnosis. Since transmastoid approach gives a wide operative field, it enables a sure and safe biopsy, and is preferable to myringotomy for biopsy. Three of our cases were malignant. The relatively high rate of malignancy suggested the need for biopsy, even when the symptoms were minimal. The clinical manifestations and image findings cannot rule out the possibility of malignancy.
