<prompt> Earliest symptom of glomus tumour is:Pulsatile tinnitusDeafnessHeadacheVertigo  <response>: Pulsating tinnitus: Ref: 214-LT, 140-D 107-D 4th 97-Maqbool 11thGLOMUS TUMOURS: Arise from glomus bodies which lies on the dome of the bulb of the IJV in the hypotympanumI Glomus Jugulare spreads widely throughout the temporal boneII Glomus tympanicum often behaves as an indolent middle ear polyp. Earliest symptom of a glomus tumour is pulsating tinnitus. this will be followed by blood stained otorrhoea, deafness and earache Browne sign - increasing the pressure in EAC by the Siegles specula makes the tumour mass more prominent and red, with increased pulsations 97-Maqbool 11th These tumours are very vascular and locally invasive Distant metastasis are exceptionally rareInvestigation NMR scanning will demonstrate soft tissue extension Jugular venography may demonstrate the extent of tumor invasion in to the jugular bulb. Carotid angiography and vertebral angiography will demonstrate the blood supply of the tumor 