1/124. facial paralysis: a presenting feature of rhabdomyosarcoma.The purpose of this paper is to present a child with embryonal rhabdomyosarcoma involving the left middle ear, who initially presented with unilateral facial paralysis. A 5-year-old boy presented with a 4-week history of left-sided facial weakness, associated with persistent otitis media on that side. Examination revealed complete left lower motor neuron facial weakness and hearing loss. A myringotomy revealed a soft tissue mass behind the tympanic membrane. biopsy and oncologic assessment confirmed a stage II, group III left middle ear embryonal rhabdomyosarcoma. Despite debulking surgery, local irradiation and multiple chemotherapeutic courses the child deteriorated quickly. He developed carcinomatous meningitis and died 9 months after his initial presentation. In conclusion, middle ear tumors should be considered in the differential diagnosis of unresolving otitis media, particularly when associated with persistent ipsilateral facial paralysis. An ear mass, discharge, facial swelling, or systemic symptoms may be initially absent despite the presence of this aggressive malignancy. Careful examination of the middle ear is recommended in children with facial weakness. A myringotomy incision may be necessary including a complete assessment of the middle ear cavity, particularly when there is no fluid return.- - - - - - - - - - ranking = 1keywords = hearing loss, hearing (Clic here for more details about this article) |
2/124. KTP laser assisted excision of glomus tympanicum.A 39-year-old female with a two-year history of mild hearing loss and discomfort on air flight descent was found to have a pulsatile mass behind an intact tympanic membrane. A suspected diagnosis of glomus tympanicum was confirmed by computed tomography (CT) scan imaging. The lesion filled the mesotympanum and hypotympanum but the jugular bony plate was intact, confirming the tympanic site of the lesion. This very vascular tumour was exposed by a tympanomeatal flap and the KTP laser used to shrink and coagulate the tumour progressively with minimal haemorrhage and blood loss. Complete excision of the lesion was achieved without the need for bony removal, and with minimal blood loss. The use of the KTP laser to coagulate this vascular lesion allowed safe removal of the tumour and avoided the need for extended facial recess or hypotympanotomy surgery.- - - - - - - - - - ranking = 1keywords = hearing loss, hearing (Clic here for more details about this article) |
3/124. Intracochlear schwannoma and cochlear implantation.A case of intracochlear schwannoma in a 58-year-old candidate for cochlear implantation is described. The tumor was located in the basal turn of the cochlea and was discovered only during surgery. Computed tomography and magnetic resonance imaging obtained prior to surgery failed to detect the tumor. Intralabyrinthine schwannomas are rare tumors that grow either in the vestibule, as intravestibular schwannomas, or in the cochlea, as intracochlear schwannomas. Complete removal of this tumor was achieved through a posterior tympanotomy approach. cochlear implantation, which resulted in good hearing, was successfully performed 3 years later.- - - - - - - - - - ranking = 0.32349146836917keywords = hearing (Clic here for more details about this article) |
4/124. Cavernous angioma of the internal acoustic meatus--case report.A 39-year-old female presented with an intrameatal cavernous angioma manifesting as hearing loss and tinnitus in the right ear which progressed over 8 months. Magnetic resonance (MR) images revealed an intrameatal lesion as ultra-high intensity, nearly as bright as cerebrospinal fluid, on the T2-weighted images, and isointensity on the T1-weighted images. Computed tomography (CT) showed the mass accompanied by stippled patterns of calcification. The patient underwent surgery under a diagnosis of calcified acoustic neurinoma. Histological studies were compatible with cavernous angioma. Intrameatal cavernous angioma is a rare disease which requires differential diagnosis from the more common neurinoma or meningioma in this location. Intrameatal lesion with ultra-high intensity on T2-weighted MR imaging and stippled patterns of calcification on CT is more likely to be cavernous angioma than acoustic neurinoma. These neuroimaging features are important information in deciding the treatment strategy.- - - - - - - - - - ranking = 1keywords = hearing loss, hearing (Clic here for more details about this article) |
5/124. Middle ear adenoma with neuroendocrine differentiation.The lining of the middle ear cleft is normally a thin modified respiratory type mucosa. Normal mucosa of the middle ear is devoid of salivary type seromucous glands. Middle ear adenoma is a rare tumor that seems to be derived from the middle ear mucosa. This tumor has been previously described under a variety of names because of its different nature and biological behavior. We herein report a case of middle ear tumor that shows adenomatous and neuroendocrine features. A 64-year-old woman presented with a history of hearing loss, tinnitus and stuffy feeling of the right ear. The patient was treated two times for ear polyp. She finally underwent a tympanomastoidectomy and there was no evidence of recurrence 18 months after the procedure. Histopathological examination displayed cuboidal and columnar cells, arranged as glands, trabeculae and solid sheets. Neuroendocrine differentiation was revealed by immunohistochemical staining with polyclonal antibodies against neuron specific enolase and chromogranin antigens.- - - - - - - - - - ranking = 1keywords = hearing loss, hearing (Clic here for more details about this article) |
6/124. Cavernous hemangioma of the internal auditory canal arising from the inferior vestibular nerve: case report and review of the literature.OBJECTIVE: To describe a case of cavernous hemangioma arising from the inferior vestibular nerve, limited to the internal auditory canal. STUDY DESIGN: Retrospective case review and review of literature. SETTING: A tertiary referral clinic. INTERVENTIONS: Extended middle cranial fossa surgery. RESULTS: The hemangioma was completely resected through the extended middle cranial fossa approach. No serious complications occurred, and the hearing and the facial nerve function were preserved. CONCLUSIONS: Originating from the capillary plexus surrounding Scarpa's ganglion, this hemangioma has to be differentiated from intratemporal hemangioma at the geniculate ganglion. Because of extrinsic growth pattern, the potential for preservation of the facial nerve function is high if surgery is performed early. Complete resection through the extended middle fossa approach is the treatment of choice for cavernous hemangioma with limited extension into the cerebellopontine angle. It remains difficult to distinguish preoperatively from the more common tumors, and surgery is usually planned on assumption of vestibular schwannoma.- - - - - - - - - - ranking = 0.32349146836917keywords = hearing (Clic here for more details about this article) |
7/124. A case of endolymphatic sac tumor with long-term survival.A 72-year-old man developed left facial palsy at age 14 and left-sided hearing loss at age 20. At the age of 59, he presented with gait disturbance, and a large left cerebellopontine angle tumor was detected, which had markedly destroyed the pyramidal bone. The tumor was subtotally resected, but he required two more operations at the ages of 64 and 69 because of tumor regrowth. At the present time, recurrent tumor has destroyed the occipital bone and is invading the scalp. However, even though he has several cranial nerve palsies and cerebellar ataxia, he remains in stable condition and demonstrates long-term survival. The patient's surgical specimens revealed a papillary adenoma, which was recently thought to be of endolymphatic sac origin, although the origin of this kind of tumor, whether arising from the middle ear or from the endolymphatic sac, has not been established with certainty so far. In this paper, we provide further evidence that this tumor originates from the endolymphatic sac, based on anatomical, histopathological, and embryological evidence.- - - - - - - - - - ranking = 1keywords = hearing loss, hearing (Clic here for more details about this article) |
8/124. Cavernous haemangioma of the internal auditory canal.Cavernous haemangiomas are rare lesions of the cerebello-pontine angle that can mimic the more commonly occurring vestibular schwannoma. A case report involving a patient with a cavernous haemangioma of the internal auditory canal (IAC) highlights this as a diagnostic possibility for lesions of the IAC by comparing and contrasting the clinical and radiological findings with the more commonly occurring vestibular nerve and facial schwannomas. Symptoms such as hearing loss and facial paralysis that are disproportionate to the size of the lesion or fluctuate with hormonal changes such as those seen in pregnancy are suggestive of haemangioma. Radiological imaging demonstrating a lesion enhancing with gadolinium and containing areas of calcification is also suggestive of haemangioma. It is important to consider the possible diagnosis of haemangioma as early recognition of this entity may improve the chances of preserving the functional integrity of the facial nerve.- - - - - - - - - - ranking = 1keywords = hearing loss, hearing (Clic here for more details about this article) |
9/124. Middle ear adenoma is an amphicrine tumor: why call it adenoma?Middle ear adenoma (MEA) is a rare tumor postulated to take origin from the lining epithelium of the middle ear cavity. The authors report on a case of MEA arising in a 53-year old woman suffering from a sensation of fullness in her left ear, otalgia, and light left-sided hearing loss. Histopathologically, the lesion was composed of cuboidal and polygonal cells displaying a trabecular, tubulo-glandular, and solid pattern of growth. Immunohistochemically, neoplastic cells diffusely stained with anti-vimentin antibodies and were focally positive for chromogranin a, neuron-specific enolase, lysozyme, and cytokeratins AE1/AE3. The majority of tumor cells showed weak and diffuse staining with both anti-PP and anti-ACTH antibodies and intense positivity with anti-glucagon and anti Leu-7 antibodies. Ultrastructural investigation revealed both mucinous-glandular and neuroendocrine differentiation. The authors suggest that the appropriate terminology would be adeno-carcinoid or amphicrine tumor of the middle ear rather than "adenoma," a term that does not reflect its dual nature.- - - - - - - - - - ranking = 1keywords = hearing loss, hearing (Clic here for more details about this article) |
10/124. Primary papillary adenocarcinoma confined to the middle ear and mastoid.Primary adenocarcinoma is a rare tumor of the middle ear and temporal bone; its most frequent symptoms are hearing loss, otalgia, and facial paralysis. Otoscopic examination of a 27-year-old man revealed purulent discharge in the ear canal, diffuse edema, and hypertrophy of the right tympanic membrane. He presented with a grade III (House-Brachman) facial paralysis and right conductive hearing loss with a history of aural discharge for 6 months, otalgia, and facial weakness for 2 days. Computed tomography of the temporal bone showed an opacity filling the tympanic cavity, antrum, and aditus. Tympanotomy revealed diffuse edema of the middle ear mucosa, and granulation tissue was encountered during mastoidectomy filling the antrum and periantral cells and eroding the fallopian canal at the level of the oval window. After the histopathological examination revealed papillary adenocarcinoma, a subtotal temporal bone resection, facial nerve segmenter resection, and end-to-end anastomosis of the facial with the hypoglossal nerves were performed. The importance of histopathological examination in all cases of chronic otitis media with granulation tissue is stressed.- - - - - - - - - - ranking = 2keywords = hearing loss, hearing (Clic here for more details about this article) |
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