Osteoma of the ear canal presenting with headache

Osteoma of external auditory canal is a rare benign tumour. Usually it is found incidentally and often symptomless. Here we have a case of osteoma arising from the anterior wall of the bony external auditory canal, causing ipsilateral temporal headache which was relieved by removal of tumour.     

Primary pleomorphic adenoma (chondroid syringoma) of the external auditory canal. Case report and literature review

Chondroid syringoma of the external auditory canal is an extremely rare neoplasm, representing the cutaneous counterpart of pleomorphic adenoma of salivary glands. This tumour is thought to derive from the apocrine duct of the folliculo-sebaceous-apocrine unit. We report the case of a 68-year-old male in whom the clinical and radiological examinations showed a well-circumscribed tumour limited to the external auditory canal. The diagnosis was confirmed by histologic examination. We also reviewed the literature.     

Schwannoma of the external auditory canal: an exceptional location

Solitary schwannoma is a benign, encapsulated tumour of Schwann cell origin, therefore the olfactory and optic nerves are never affected. About 25%-45% of all schwannomas occur in the head and neck but schwannoma of the external auditory canal is a rare finding, and we have found only 6 previous cases reported in the literature world-wide. Our patient was discovered by chance during a stapedectomy because the tumour was sited in the external auditory canal without distorting it.     

Magnetic resonance imaging of pleomorphic adenoma arising from the external auditory canal

Pleomorphic adenoma arising from the external auditory canal is a very rare neoplasm, and there has been no report on magnetic resonance (MR) imaging of pleomorphic adenoma of the external auditory canal. We report here a case of 65-year-old male with this tumour, measuring 12 mm in a diameter. Histopathology was confirmed from the specimen obtained at the surgical excision. MR revealed that the tumour had a well-defined margin showing hypointensity on T1-weighted images and hyperintensity on T2-weighted images relative to the parotid gland. The tumour was well enhanced by contrast material. No invasion to the surrounding tissue was observed. These MR findings were compatible with pleomorphic adenoma of the salivary gland origin. In treating pleomorphic adenoma of the external auditory canal, complete surgical excision is essential for the prevention of recurrence. It can be concluded that MR imaging is helpful for making a differential diagnosis of external auditory canal tumours and selection of adequate treatment.     

Osteoma of the middle ear

Osteomas involving the middle ear and causing a functional disturbance are rare. We report a case of a patient with an osteoma arising from the lateral semicircular canal. The main symptom was vertigo and to halt this the defect of the canal was obliterated with a bone chip and fibrin glue after removal of the tumour.     

Schwannoma of the external auditory canal: An exceptional site

IntroductionSchwannomas are benign solitary neural tumours that are only exceptional located in the external auditory canal, as only a few cases have been reported in the literature.Case reportWe report a case of schwannoma of the external auditory canal in an 18-year-old man admitted for an isolated mass of the initial segment of the right external auditory canal visible to the naked eye, obstructing all of the external auditory meatus. Computed tomography of the temporal bone showed an isolated mass of the external auditory canal. Management of this patient consisted of biopsy-excision of the mass, histological examination of which confirmed a schwannoma of the external auditory canal.DiscussionAlthough rare, the possibility of a nerve tumour of the external auditory canal should always be considered. These tumours may be isolated or may occur in the context of von Recklinghausen's disease. The clinical presentation in the external auditory canal may correspond to recurrent otitis externa secondary to obstruction of the canal by the tumour, as in the case reported here. The definitive diagnosis must be based on the results of histological and immunohistochemical examination.     

Schwannoma of the tympanic membrane

Schwannoma arising from the tympanic membrane is a rare neoplasm. This report describes an external ear canal mass obscuring the tympanic membrane. A transcanal approach identified a tumour adhered to the tympanic membrane. The tumour was excised without myringoplasty. Pathology confirmed the diagnosis of schwannoma. Clinical examination revealed no evidence of recurrence during a follow-up period of one year. The possible origins of schwannoma of the tympanic membrane and lesion management are also discussed.     

Tubular apocrine adenoma with syringocystadenoma papilliferum arising from the external auditory canal

Tubular apocrine adenoma (TAA) is a very rare sweat gland tumour. Comprehensive review of the literature reveals that TAA in the external auditory canal (EAC) has not yet been reported. We report a case of TAA in the EAC, together with characteristic histopathological findings.     

Ceruminoma of the External Auditory Canal adenoid cystic variety

Adenoid cystic carcinoma is a rare variety of Ceruminoma, arising from the glandular elements of the External Auditory Canal. A case of Adenoid cystic carcinoma of the external auditory canal is reported, to recapitulate clinical features and management problems of the tumour at this site. The controversies in nomenclature, histopathology, and management are discussed.     

Ectopic extra-cranial meningioma presenting as an aural polyp

Ectopic meningiomas located within the external auditory canal without any intracranial connection are an extremely rare finding. A report is made of a 38-year-old woman presenting with a conductive hearing loss due to an aural polyp, which was subsequently diagnosed as a meningioma. Computer-aided tomography (CT) and magnetic resonance imaging (MRI) showed the tumour to be entirely extracranial. Complete tumour excision was achieved using a modified radical mastoidectomy approach.     

The chondroid syringoma: report of a case arising from the external auditory canal

Chondroid syringoma is an uncommon, benign skin adnexal tumour. It usually presents as a slowly growing intradermal or subcutaneous nodule on the face. Treatment involves local excision with a cuff of normal tissue to prevent recurrence. A rare case of chondroid syringoma arising from the external auditory canal is reported. The clinical features, histology, treatment and follow-up are discussed.     

Neurofibroma in the mastoid segment of the facial canal

Neural tissue-derived facial nerve tumours usually present as neurinomas. We describe the extremely rare occurrence of a histologically verified neurofibroma primarily arising in the mastoid segment of the facial canal in a patient not fulfilling diagnostic criteria for neurofibromatosis. The tumour showed evidence of perineural growth into the jugular foramen, as suggested by cross-sectional imaging and intraoperative findings.     

Syringocystadenoma papilliferum of external auditory canal and pinna: A rare presentation

Syringocystadenoma papilliferum (SCAP) is a rare benign skin tumour characterized by extensive papillary epithelial elements growing into the dermis. SCAP often presents at birth and most commonly in the head and neck. However, it rarely involves ear. Here, we present a case of SCAP involving external auditory canal and pinna and its surgical management involving excision and split skin grafting.     

Winer''s dilated pore, rare presentation in the external ear canal

A 51-year-old female patient was admitted to our outpatient department with a discharging right ear of six months duration and not responding to aural toilet and topical antibiotics. Microscopic examination showed a collection of soggy keratin in the floor of the ear canal. Suction cleaning showed a skin defect of about 7 mm in diameter. A CT scan showed rarefaction in the bony canal. Histological diagnosis following an excision biopsy under general anaesthetic showed Winer's dilated pore. Winer's dilated pore is a hair follicle tumour arising from the pilosebaceous apparatus. Hair follicle tumours are relatively rare and their clinical appearance is commonly non-specific. In spite of their non-specific features, they show a keratotic plug grossly which when removed reveals a skin defect and may show bone erosion occasionally if the underlying structure is bone. These features can be misinterpreted for more serious lesions such as squamous cell carcinoma or basal cell carcinoma of the ear canal that can lead to pursuing a more aggressive line of management for a benign lesion. We present this rare lesion illustrating the pathological features, differential diagnosis and management.     

Pleomorphic adenoma involving the stylomastoid foramen

A rare case of an intratemporal pleomorphic adenoma is presented and the management of such a tumour is discussed. Some anatomical aspects of the facial nerve, pertinent to the pathophysiology of facial paralysis are outlined. This case demonstrates that tumour extension into the temporal bone can be resected successfully at initial surgery with excellent facial nerve functional outcome. We advocate exploration of the fallopian canal to be carried out at primary surgery and be performed by a surgeon familiar with the surgical anatomy of the intratemporal segment of the facial nerve. This approach will reduce the risk of facial nerve injury and palsy both at surgery and subsequently.     

Meningioma in the internal auditory canal

A case is presented of an entirely intracanalicular meningioma in a 48-year-old woman that was excised via a conventional translabyrinthine approach to the internal auditory canal (IAC). Pre-operative magnetic resonance imaging (MRI) suggested that the tumour was a vestibular schwannoma (VS). Histological examination confirmed the intra-operative impression that the tumour was a meningioma. Although VS is by far the commonest intracanalicular tumour, the differential diagnosis includes meningioma. MRI is unable to distinguish between these two entities when the tumour is located entirely in the internal auditory canal.     

A case of osteoma with cholesteatoma in the external auditory canal

Osteoma in the external auditory canal (EAC) is an uncommon benign lesion, which presents as a solitary, unilateral, and slow-growing pedunculated mass in the outer half of the bony canal. It is usually asymptomatic; but symptoms can arise if a canal obstruction occurs. External canal cholesteatoma is also a rare lesion of the external auditory canal. Cholesteatoma of the external auditory canal may arise via several mechanisms. However, an occlusion or narrowing of the external auditory canal is the basic pathogenesis. The association of an osteoma with a cholesteatoma is extremely rare, and there have been very few reports published. We encountered a rare case of a 49-year-old man with an osteoid osteoma that was complicated by a cholesteatoma in the external auditory canal. The canal wall down mastoidectomy and tympanoplasty successfully removed the osteoma and the cholesteatoma, and no recurrence or complications had occurred in the first 6 months postoperatively.     

Squamous carcinoma of the external auditory canal: a different approach

Squamous carcinoma of the external ear canal is a rare disease and a challenge to treat. Some controversy exists regarding the best options for treatment. Reported 5-year survival varies between 35% and 63%. Since 1976, we have adopted a conservative approach to these tumours, with patients undergoing a specific protocol of meticulous tumour debulking followed by a course of repeated topical 5-fluoro-uracil (5-FU) cream application and necrotectomy. Data was collected prospectively. From 1976 to 1998, 23 patients underwent primary treatment according to our protocol. Nine patients had T1 disease whereas six had T2 and eight had T3 disease. The 5- and 10-year overall survivals were 74% and 60% respectively. These results compare very favourably with those in the literature and surgical debulking with topical 5-FU and necrotectomy remains our primary treatment of choice for squamous cell carcinoma of the external auditory canal.     

Malignant clear cell hidradenoma of the external auditory canal

A patient with a clear cell (malignant) hidradenoma of the external auditory canal and a detailed review of the literature are presented. Tumours of the ceruminous glands are rare. A sub-classification into distinct histological tumour types is useful with respect to therapy and prognosis. About two-thirds of all these neoplasms are malignant and the frequency of recurrence is very high (50%). Most of the adenomas are not encapsulated. The well differentiated adenocarcinomas (low grade malignancy) of the ceruminous glands can only be distinguished histologically from adenomas by their tendency to invade and infiltrate. Therapy of the ceruminous adenomas is wide excision; the treatment of carcinoma is radical block resection.     

Duplicated internal auditory canal with inner ear malformation: Case report and literature review

Internal auditory canal anomalies are rare. Narrow internal auditory canal is believed to occur as a result of aplasia or hypoplasia of the vestibulocochlear nerve. Narrow duplication of the internal auditory canal is considered to be very rare. Narrow duplication of the internal auditory canal with inner ear malformation has been reported in only 3 cases. We present 2 cases of narrow duplication of the internal auditory canal with inner ear malformation. The first case had inner ear malformation on only one side and the second case had inner ear malformation on both sides. The embryogenesis may be different between internal auditory canal and inner ear.