March 24, 2013 Teresa Pusiol, MD; Ilaria Franceschetti, MD; Francesca Bonfioli, MD; Francesco Barberini, MD; Giovanni Battista Scalera, MD; Irene Piscioli, MD
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Abstract
We describe an unusual case of breast cancer metastatic to the middle ear in a 71-year-old woman. The metastasis was the initial sign of disseminated disease 20 years after the patient had undergone a quadrantectomy for her primary disease. Computed tomography (CT) demonstrated the presence of an intratympanic mass with a soft-tissue density that was suggestive of chronic inflammation. The patient underwent a canal-wall-down tympanoplasty. When a brownish mass was found around the ossicles, a mastoidectomy with posterior tympanotomy was carried out. However, exposure of the tumor was insufficient, and therefore the posterior wall of the ear canal had to be removed en bloc. Some tumor was left on the round window membrane so that we would not leave the patient with a total hearing loss. Our case highlights the limitations of CT and magnetic resonance imaging in differentiating inflammatory and neoplastic lesions.
February 25, 2013 Willis S.S. Tsang, FRCSEd(ORL); Michael C.F. Tong, MD(CUHK); C. Andrew van Hasselt, M Med(Otol)
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Extrusion of ossicular prostheses results from postoperative tympanic membrane medialization. The incorporation of cartilage grafting material is recommended to minimize extrusion.
December 31, 2012 Waitsz T. Chang, MRCS; Willis S.S. Tsang, FRCSEd(ORL)
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For the treatment of a small glomus tympanicum, surgical excision via an anterior tympanotomy approach is possible.
September 7, 2012 Michael W. Chu, MD; Alice Werner, MD; Stephanie A. Moody-Antonio, MD
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Abstract
Juvenile xanthogranuloma (JXG) is a benign, non-Langerhans cell histiocytic lesion that generally affects infants and children. These lesions characteristically appear as a solitary, yellow, cutaneous nodule of the head, neck, or trunk. Subcutaneous and extracutaneous forms can involve the gastrointestinal tract, kidney, lung, gonads, pericardium, central nervous system, temporal bone, larynx, and eye. We describe the clinical presentation, imaging, histochemical findings, and management of a solitary JXG of the tympanic membrane in a 17-month-old girl. The patient underwent surgical resection and was without disease several months following surgery and reconstruction of the defect. To the best of our knowledge, this is the first reported case of a JXG of the tympanic membrane.
September 7, 2012 Jae Hoon Lee, MD
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Hemotympanum can be caused by temporal bone fractures, barotrauma, administration of anticoagulants, hematologic disorders, and chronic otitis media secondary to the formation of granulation tissue or a cholesterol granuloma. It can also occur secondary to nasal packing or spontaneous epistaxis, as well as eustachian tube dysfunction.
June 4, 2012 Lisa Cramer, BA; Dina M. Emara, MBBCh; Arun K. Gadre, MD, FACS
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Despite common belief, Mycoplasma pneumoniae is an extremely rare causative agent for bullous myringitis. Instead, it is caused by the same organisms responsible for acute otitis media.
April 30, 2012 Joseph A. Ursick, MD; Jose N. Fayad, MD
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Cholesteatomas are believed to form as the result of poor eustachian tube function with resultant tympanic membrane retraction and a lack of normal epithelial migration.
February 18, 2012 John C. Goddard, MD and Jose N. Fayad, MD
December 15, 2011 Stanley Pelosi, MD and Sujana S. Chandrasekhar, MD, FACS
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Abstract
We discuss the rare case of a 68-year-old woman with Vogt-Koyanagi-Harada (VKH) syndrome and sensorineural hearing loss (SNHL) who was successfully treated with intratympanic corticosteroid injections. The patient had presented with bilaterally asymmetric (i.e., moderate and moderate to severe) SNHL, tinnitus, vertigo, and vitiligo. She received two intratympanic injections in her worse-hearing ear over the course of 1 month. Subsequent audiometry showed an immediate 5- to 10-dB improvement in her hearing across multiple frequencies, as well as a long-term improvement to near-normal thresholds. The hearing thresholds in her untreated ear remained stable. To the best of our knowledge, this is the first report of a patient with VKH syndrome who was successfully treated with intratympanic steroid application.
December 15, 2011 Byung Don Lee, MD and Moo Kyun Park, MD
April 30, 2011 Min-Tsan Shu, MD and Yu-Chun Chen, MD
April 30, 2011 Hatice Gul Hatipoglu, MD, Mehmet Ali Cetin, MD, Enis Yuksel, MD, and Huseyin Dere, MD
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Abstract
We describe the case of a 37-year-old woman who presented with a complaint of recurrent headaches since childhood. Clinical examination revealed the presence of a reddish-bluish mass in the inferior half of the tympanic membrane in her right ear. Source and three-dimensional time-of-flight magnetic resonance angiography (MRA) detected a protruded right internal carotid artery (ICA) in the hypotympanum. The vertical segment of the ICA was absent, and the artery was narrowed and lateralized and had a “reverse 7” shape. Meanwhile, a persistent stapedial artery (PSA) was seen originating in the petrous portion of the ICA to form a middle meningeal artery. The A1 segment of the right anterior cerebral artery was hypoplastic. Based on these findings and on follow-up findings on computed tomography, the patient was diagnosed with a concomitant aberrant ICA and PSA. No intervention was undertaken. We review the management of this rare finding, and we discuss the role of MRA in its diagnosis.
