Abstract
Osteomas of the middle ear are rare benign neoplasms. To date, only a few cases have been reported. Osteomas of the middle ear are small, single, usually unilateral, peduncular growths, off-white in color, with a smooth or multilobular surface, asymptomatic or causing functional disorders. The most common symptom is conductive hearing loss because of impingement of the ossicular chain. Some cases are asymptomatic and are diagnosed incidentally. We present two cases of incidentally detected middle ear osteoma. Based on a review of the main articles in the literature and analysis of two cases managed in our department, we describe the clinical spectrum, etiology, and management of middle ear osteomas.
1
Introduction
Temporal bone osteomas are benign tumors of lamellar bone which are most commonly found in the external auditory canal (EAC). Osteomas in the middle ear are tumors that are rarely seen. Most are confined to the mesotympanum and cause conductive type, unilateral and progressive hearing loss . Some osteomas are asymptomatic and are diagnosed incidentally. Temporal bone osteomas usually occur in young patients, and present as a single unilateral lesion, of unknown etiology. The goal of this paper is to report two cases of middle ear osteoma and delineate the clinical spectrum by reviewing 34 published cases.
2
Case reports
2.1
Case 1
A 13-year-old boy presented to our department for evaluation and a white mass was detected in his right ear. Otoscopic examination of the right ear showed the white mass behind the intact tympanic membrane (right) in the anterior tympanic cavity ( Fig. 1 A ). The patient denied tinnitus, trauma, prior surgery, ear infection or vestibular symptoms. Otoscopy of the left ear revealed an intact tympanic membrane.
