Middle Ear

Aggressive papillary tumor of the middle ear: A true entity or an endolymphatic sac neoplasm?

June 30, 2008     James R. Tysome, MA, MRCS, Jonny Harcourt, MA, FRCS, Manish C. Patel, FRCR, Ann Sandison, FRCPath, and Leslie Michaels, MD, FRCPath
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Abstract

Aggressive papillary tumors of the middle ear are rare, and their true origin is not clear. We describe the clinical, radiologic, genetic, and histopathologic features of a papillary epithelial tumor filling the middle ear of a 68-year-old woman. Imaging revealed no evidence of petrous temporal bone apex involvement, nor did genetic studies demonstrate the von Hippel-Lindau mutation. A literature search revealed 24 previously reported cases of such a papillary epithelial tumor of the middle ear. All except 2 cases demonstrated apical petrous temporal bone invasion on imaging, and it has been suggested that they arose from a primary endolymphatic sac tumor, which has a similar papillary epithelial histology. Substantial numbers of cases of papillary epithelial tumors involving the middle ear are reported to be associated with von Hippel-Lindau disease, as are known cases of endolymphatic sac tumor. This is the third reported case of papillary epithelial tumor of the middle ear that does not show apical petrous temporal bone invasion on imaging, suggesting that such neoplasms do not always arise from a primary in the endolymphatic sac.

Acute suppurative otitis media

April 30, 2008     Eric P. Wilkinson, MD and Rick A. Friedman, MD, PhD
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Aberrant ectatic internal carotid artery in the middle ear

March 31, 2008     Adnan Safdar, FRCS, Joseph P. Hughes, FRCS, and Rory McConn Walsh, FRCS
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Abstract

We report the case of a 34-year-old man with pulsatile tinnitus and a reddish mass in the anteroinferior quadrant of the middle ear. Physical examination and imaging were unable to establish a diagnosis, so an exploratory tympanotomy was performed. Exploration revealed the presence of an ectatic aberrant internal carotid artery in the middle ear. Aberrations of the internal carotid artery in the middle ear are rare. Even so, our case is unusual in that all initial investigations had failed to establish the diagnosis. This case highlights the limitations of modern imaging techniques in certain situations.

Spontaneous cerebrospinal fluid leak presenting as unilateral (left-sided) middle ear effusion

February 1, 2008     Kavadi T. Rajkumar, MBBS, DLO, Ahmed A. Orabi, FRCS, MSc, and Michael S. Timms, FRCS
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Abstract

Spontaneous leak of cerebrospinal fluid (CSF) into the middle ear occurs rarely and can easily be missed, especially in adults. Although the presenting symptoms can be subtle, early suspicion and confirmatory imaging can establish the diagnosis. Most previously reported cases of spontaneous CSF leak into the middle ear occurred on the right side. We report a case of left-sided single-defect spontaneous leak.

Migration of T-tubes to the middle ear

January 1, 2008     Thabet Abbarah, MD, FACS and M. Aiman Abbarah, MD
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Systemic effects of ototopical dexamethasone

October 31, 2007    
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Relative value of different fluoroquinolones

October 31, 2007    
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Congenital middle ear cholesteatoma

October 31, 2007     J. Walter Kutz Jr., MD and Rick A. Friedman, MD
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