Introduction: Congenital cholesteatoma (CC) of the middle ear is a rare entity that may be undiagnosed for years. The lesion can grow undetected until it produces symptoms such as reduced hearing or otalgia.

Glomus tympanicum is a tumour classified under the group glomus tumours, and is also knownas paragangliomas. It is thought to commonly occur in women in the fifth to sixth decades of life.Here, we report a case of a 77-year-old lady with multiple co-morbids and a diagnosis of glomustympanicum presenting to us. Her symptoms included pulsatile tinnitus, and reduced hearing,and the management of the case was done with consideration for her underlying multiple comorbidities.This paper also describes the best modality of treatment for this patient with regardto her background history. The treatment goal was to improve her quality of life and control thedisease.