Capillary hemangiomas of the tympanic membrane are extremely rare benign vascular tumors. These lesions may be asymptomatic or associated with tinnitus, otalgia, or hearing loss. We present a case of an asymptomatic capillary hemangioma of the tympanic membrane excised without complications. An internal review board exemption was obtained.
A 59-year-old woman with a history of bilateral nonpulsatile tinnitus and mild high-frequency sensorineural hearing loss presented to her local otolaryngologist for cleaning of recurrent cerumen impactions. She was found to have a vascular lesion on her left tympanic membrane that was not evident at her last cleaning. She noted no change in her hearing or tinnitus and denied trauma, aural fullness, otalgia, otorrhea, vertigo, and headache. She has no hemangiomas elsewhere. On physical examination, there was a 3-mm ovoid nonpulsatile lesion on the lateral surface of the tympanic membrane, just superior to the umbo ( Fig. 1 ). The rest of the patient’s head and neck examination was unremarkable. Audiogram demonstrated bilateral symmetric mild high-frequency sensorineural hearing loss. Magnetic resonance imaging and computed tomography scans demonstrated a small lesion lateral to the tympanic membrane without extension into the middle ear. The patient was taken to the operating room for excisional biopsy. The lesion was removed, leaving the fibrous and mucosal layers intact. Pathologic examination showed a well-circumscribed lesion with small vascular spaces and endothelial cells within a fibrous stroma. The lesion was encapsulated on one side with squamous epithelium, consistent with the lateral surface of the tympanic membrane.
