Salivary gland choristoma of the middle ear

Choristoma is a mass of tissue histologically normal for an organ or part of the body other than the site at which it is located. A rare case of ectopic salivary gland choristoma in the middle ear is described in a 14-year-old girl whose only symptom was a 55 dB conductive hearing loss. The left middle ear mass appeared whitish and was located behind the intact tympanic membrane. We first suspected it to be congenital middle ear cholesteatoma. Exploratory tympanotomy, however, revealed a salivary gland choristoma that adhered tightly to the facial nerve. Differential diagnosis and treatment of this rare condition are discussed.     

Salivary gland choristoma of the middle ear in a child with situs inversus totalis

Salivary gland choristoma of the middle ear cavity is an extremely rare entity. It is thought to be a developmental abnormality and may be associated with abnormalities of adjacent structures. We report a case of salivary gland choristoma of the middle ear with prominent Körner's septum in a 7-year-old girl with situs inversus totalis. Situs inversus totalis is the mirror image reversal of the normal position of the internal organs and frequently associated with other congenital anomalies. This patient is the first reported case with situs inversus totalis, having middle ear salivary gland choristoma and prominent bilateral Körner's septae. The management and the differential diagnosis of this condition are discussed with the review of the literature.     

Salivary gland choristoma of the middle ear: a case report

A choristoma is a nonneoplastic proliferation of histologically normal tissue that forms at an abnormal site. It is extremely uncommon in the middle ear space. It appears to be a developmental abnormality and may be associated with abnormalities of adjacent structures. It usually occurs with unilateral conductive hearing loss and requires a differential diagnosis from other mass lesions in the middle ear cavity. This article discusses a case of salivary gland choristoma of the middle ear that we believe to be the 24th case reported on this subject.     

Pleomorphic adenoma of the middle ear and mastoid with posterior fossa extension

We describe the case of a pleomorphic adenoma of the middle ear and mastoid, with extension into the posterior cranial fossa. The lesion was characterized by extensive bony destruction and close proximity to the facial nerve. Ectopic or choristomatous salivary gland tissue within the middle ear cleft is the most probable origin of this tumor.     

Salivary gland choristoma (hamartoma) of the middle ear: a case report

OBJECTIVE: Middle ear salivary gland choristoma are extremly rare. We report a case, describe the clinical management and review the literature. CLINICAL CASE: A 12 year old boy presented with unilateral conductive hearing loss associated with a large inferior retraction pocket on otoscopy. CT scan demonstrated a large mass in the left middle ear cavity. The incus was absent and the stapes was partially eroded. Middle ear exploration demonstrated an 8 mm yellow/red mass in the region of the fallopian canal. This mass was comptly removed and histopathology confirmed salivary gland choristoma. CONCLUSION: These lesions result from an abnormal development of the second branchial arch. It is important to consider these lesions as part of the differential diagnosis for any unilateral hearing loss associated with a middle ear mass in children.     

Choristomatous polyps of the aural and pharyngeal regions: first simultaneous case

The first known case of embryological development of a salivary gland choristoma of the middle ear and a hairy teratoid (choristomatous) mass of the pharynx arising in the same patient is reported. On the day after the patient, a female, was born, a posterior pharyngeal mass was discovered, resected, and diagnosed histopathologically as a hairy teratoid (choristomatous) polyp. At 10 months of age, the patient underwent myringotomy and tympanostomy tube placement, and another mass was found in the left middle ear. This mass was diagnosed as a salivary gland choristoma. Our review of the literature showed that, consistent with our case, choristomas are more prevalent in females, and those in the middle ear almost always occur on the left side. Both types of polyps are rare and are thought to be due to errors in development of the second and first branchial arches.     

A case of syryngocystadenoma papilliferum (SCAP) involving middle ear, presenting with otomastoiditis and cerebral abscess

Syryngocystadenoma papilliferum (SCAP) is an uncommon cutaneous adnexal neoplasm of apocrine gland origin. Until now, fewer than 200 cases have been reported in international literature, of which 12 cases involved the external ear. No cases of SCAP involving the middle ear have been reported. We describe a case of SCAP of external and middle ear, presenting with otomastoiditis and cerebral abscess; this aggressive behavior, never reported for a benign adenoma of the external or middle ear, could lead to a differential diagnosis with cholesteatoma or malignancies.     

Primary adenocarcinoma of the middle ear.

Primary adenocarcinoma of the middle ear is rare. It may or may not be associated with chronic suppurative otitis media. After the exclusion of a primary site elsewhere, the tumor should be managed by surgery and postoperative radiotherapy, especially if tumor excision is incomplete. We report a case in which primary papillary adenocarcinoma developed in the middle ear, possibly due to aberrant ceruminous gland elements. The findings prior to histologic examination were unusual in that they were consistent with a tumor of the glomus tympanicum or glomus jugulare.     

Salivary gland choristoma of the middle ear.

A salivary gland choristoma is an extremely uncommon tumour in the middle ear space. It appears to be a developmental abnormality and may be associated with abnormalities of adjacent structures. It usually presents with unilateral conductive deafness which may be long-standing and the tumour often pursues a benign, slow growing course. It is usually possible to excise it, but problems may arise as there may be variable associated anatomical abnormalities of the middle ear. We present the nineteenth recorded case, review the literature and discuss the management of this condition.     

Salivary gland choristoma in the middle ear: a case report.

Salivary gland choristoma (ectopic or heterotopic salivary gland tissue) is a rare condition that occurs in various locations within the head and neck regions. We present a 13-year-old boy with a salivary gland choristoma in the middle ear associated with congenital alopecia around the auricle in addition to facial nerve and ossicular chain abnormalities. Because the lesions commonly involve the facial nerve, intraoperative facial nerve monitoring is helpful in allowing safe biopsy without facial nerve damage.     

Salivary gland choristoma of the middle ear in an infant: a case report

Salivary gland choristoma of the middle ear cavity is an extremely rare entity. Many patients with this entity usually present with conductive hearing loss. Many reports concentrate on the importance of conservative treatment of choristoma for fear of the possible injury of the facial nerve. We report another case of salivary choristoma of the middle ear in an 11-month-old girl. We performed a reconstruction surgery of the hearing mechanism, as well as tumor removal, and achieved satisfactory hearing results. If no remarkable facial nerve anomaly is detected in the preoperative evaluation, the reconstruction of the hearing mechanism with complete tumor removal might be considered.     

Salivary gland choristoma of the middle ear: case treated with KTP laser

Salivary gland choristoma of the middle ear is rare. It consists of non-malignant, non-growing, normal salivary gland tissue in the middle ear. It is a developmental abnormality that occurs around the proximal part of the second branchial arch before the fourth month of intrauterine life. The authors found the 25th recorded case in our centre and another 24 reported cases from a review of the literature between 1961 and 1999. Intratympanic salivary gland choristoma frequently occurs during the first and second decades of life and with a female preponderance (56 per cent). Nearly all the patients (96 per cent) in our review presented with a hearing loss, that had begun since birth, in infancy, or during childhood. Tinnitus (28 per cent), and serous otitis media (24 per cent) were also commonly present. One case complained of otorrhoea. Intratympanic and extratympanic anomalies were found in 96.2 per cent and 34.6 per cent of cases respectively. Of these anomalies, ossicular chain (88.5 per cent), facial nerve (65.4 per cent), middle-ear muscles (30.8 per cent) and labyrinthine windows (23 per cent) were the four most common sites. Therefore, salivary gland choristoma may represent a manifestation of a congenital ear anomaly. Diagnosis of salivary gland choristoma is generally not documented pre-operatively, but is based on surgical biopsy and histopathological investigations. Treatment of this rare lesion depends on the size, location and extent of the mass, degree of anatomical abnormality and expertise of the surgeon. In difficult cases where the mass is attached to the dehiscent or inferiorly placed facial nerve, only biopsy is recommended. However, complete surgical removal is advocated for a mass that is easy to remove. KTP laser use via a 200 micron fibre-optic light carrier can facilitate removal especially in cases with ossicular chain involvement.     

PRIMARY MUCOEPIDERMOID TUMOR OF THE MIDDLE EAR AND MASTOID

Mucoepidermoid tumors are salivary gland neoplasms located mainly in the parotid gland. We present an unusual case of such a tumor arising from the middle ear and mastoid cavity successfully treated by surgery and post-operative radiotherapy.     

Choristoma of the middle ear

Choristoma is a mass of tissue histologically normal for an organ or part of the body other than the site at which it is located. A rare case of ectopic salivary gland choristoma in the middle ear is described in a 4-year-old boy whose only symptom was a 50 dB conductive hearing loss in the presence of a normal tympanic membrane.     

Tuberculosis of the head, neck and ear--a rare disease?

Between 1980 and 1984 we treated 9 patients with tuberculosis of the lymph nodes, middle ear, parotid gland, larynx and sphenoid sinus. Diagnosis is difficult because of the unusual courses of the disease, the special pathways of infection and because tuberculosis is rarely suspected as the diagnosis. The importance of a combined conservative-surgical therapy is stressed.     

Epidermoidzyste als Raumforderung der Glandula parotis

Epidermoid cysts of the parotid gland are rare. We report the case of a 60-year-old man with a cystic tumor of the right parotid gland. The patient had undergone ipsilateral middle ear surgery twice four years previously. The tumor was identified by computed tomography and ultrasonography and removed by total parotidectomy under suspicion of a parotid tumor. Histopathology revealed the diagnosis of an epidermal cyst. The differential diagnosis of a parotid tumor should include (iatrogenic) epidermoid cyst, in particular if there is a history of prior ear surgery via an endaural approach.     

Management of the ear canal in head and neck surgery

The management of the ear canal in the treatment of tumors occurring in the area of the head and neck is a highly specialized problem. The material for this report is a derivative of the treatment of tumors involving the auricle, tragus, the skin of the cheek, temple, mastoid, parotid gland, ear canal, and middle ear. The extensive variety of histopathologic conditions and positions of the various tumors creates special problems in preserving and reconstructing the ear canal, saving the tympanic membrane, and rehabilitating the area of the ear canal when these structures have had to be resected. Six basic techniques have been used in rehabilitating this unique area, by using regional skin, free skin grafts, regional flaps, cervical flaps, combinations of these techniques, and large cutaneous and myocutaneous chest and back flaps for the larger ablations.     

Malignancies of the external ear canal and temporal bone: surgical techniques and results

A combined therapy approach to malignancies of the external auditory canal and middle ear has been developed. A technique of external canal resection and gross tumor removal from the middle ear, parotid gland, and superior cervical lymph nodes is followed by postoperative full-therapy irradiation. This combined approach has been used in 30 patients with malignancies involving the external auditory canal and temporal bone. The preoperative evaluation and surgical technique, including the intraoperative decision-making process, is described. Twenty-four patients had squamous cell carcinoma of the external auditory canal, and two patients had basal cell carcinoma. There was one patient each with adenocystic carcinoma, acinic cell carcinoma, high grade mucoepidermoid carcinoma, and a giant cell tumor of bone. This group of patients was broken down into three groups based on the extent of disease as determined at surgery. Overall control of disease, both locally and distant, for the 30 patients was 66%. There were 12 patients with disease limited to the ear canal. These patients had a 91% survival of this disease process. Seven patients were determined to have limited extension beyond the ear canal. These were treated with combined therapy with an overall control of disease of 72%. Eleven patients had extensive disease outside of middle ear into the carotid jugular spine, stylomastoid foramen, and skull base, with a survival rate of 45%. It is concluded that a step-wise removal of all gross tumor, as opposed to an en bloc dissection of the temporal bone and skull base, followed by full-therapy irradiation gives equally as good, or even better, long-term survival for this malignancy of the external auditory canal and middle ear.     

Anatomy of the chinchilla bulla and eustachian tube: I. Gross and microscopic study

The middle ear mucosa and eustachian tube of the normal chinchilla were studied quantitatively and under light microscopy to determine the distribution of each cell type of the lining epithelium and subepithelial gland. The middle ear mucosa consisted of columnar epithelium, cuboidal epithelium, and squamous epithelium. The lining epithelium of the eustachian tube was ciliated pseudostratified columnar epithelium. These epithelia were composed of ciliated, secretory, nonciliated (nonsecretory), and basal cells. The density of the ciliated cells was highest in the columnar epithelium area of the transitional zone of the middle ear mucosa. However, the density of the secretory cells was highest in the pharyngeal orifice of the eustachian tube. The nonciliated cell density was highest in the squamous epithelium area of the middle ear mucosa and decreased progressively toward the tympanic orifice of the eustachian tube. In the eustachian tube, the nonciliated cell density was highest in the pharyngeal portion of the eustachian tube, especially in the upper portion of the lateral wall. The subepithelial glands were tubuloacinar mixed glands composed of serous demilunes and mucous acini. The glands were localized primarily in the pharyngeal orifice and pharyngeal portion of the eustachian tube, and their ductal openings were present primarily in the inferior portion of the eustachian tube.     

中耳癌的诊断与治疗(附19例分析)

目的 探讨中耳癌的诊断与治疗。方法 我院1994年5月至2003年8月收治中耳癌患者19例,其中鳞癌17例、耵聍腺癌和乳头状瘤恶变各1例;14例手术+放射治疗,1例放疗＋化疗,2例化疗,2例未治疗。结果 随访5年以上,3年存活率31.2％（6/19）,5年存活率10.5％（2/19）。结论 以手术为主结合放化疗的综合措施是本病的最佳治疗手段,准确的临床分期是选择方案的主要依据,乳突术腔的定期观察和处理是防止复发的重要措施,复发后合理治疗仍有一定的效果。