Brown sign is seen in:

Brown's sign: When pressure in middle ear is raised the glomus tumor pulsates then blanches, reverse happens when pressure is released. Glomus tumour: a. MC benign neoplasm of middle ear b. MC site - hypotympanum. c. It is an non chromaffin paraganglioma derived from neural crest commonly affecting middle aged female. Clinical Features :- a. Earliest symptoms are deafness and tinnitus b. Otoscopy shows red reflex, rising sun appearance; tympanic membrane appears bluish and bulging c. Brown's sign d. Pulsation sign Diagnosis: a. CT scan head to distinguish glomus jugulare from tympanicus by identification of coicojuglare spine which is eroded in glomus jugulare (Phelps' sign). b. HRCT and Gadolinium enhanced MRI to delineate extent of tumour c. Four vessels angiography d. Treatment: e. Surgery: TOC: Lateral cranial base surgical removal with preoperative embolization. Radiation for inoperable, residual, recurrent tumor f. Embolization: Inoperable patients after radiation therapy