[Bilateral temporal bone xanthoma associated with hyperlipidemia]

Area of Science:

• Otolaryngology
• Dermatology
• Metabolic Disorders

Background:

• Xanthomas are lipid deposits that can occur in various body tissues.
• Temporal bone xanthomas are rare, often presenting diagnostic challenges.
• Previous treatment for external otitis media and mastoiditis complicated the initial diagnosis.

Observation:

• A 42-year-old patient presented with bilateral temporal bone xanthomas.
• The patient had a history of recurrent external otitis media and mastoiditis.
• Hyperlipidemia was diagnosed only after the establishment of xanthoma diagnosis.

Findings:

• Histological and clinical data differentiated xanthomas from chronic otitis media.
• Preserved auditory ossicles and hearing despite significant temporal bone destruction.
• Volumetric formations extended into the cranial cavity without contrast enhancement on imaging.
• Hearing improved with body warming, suggesting fat 'melting' and ear canal opening.
• Fistulas with yellowish discharge acted as a 'release valve', preventing cerebral complications.

Implications:

• Highlights the importance of considering metabolic disorders in complex ear pathologies.
• Suggests a potential link between hyperlipidemia and temporal bone xanthoma development.
• Demonstrates the value of comprehensive diagnostic approaches, integrating clinical, histological, and imaging data.
• Emphasizes the 'release valve' function of fistulas in preventing severe complications.