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High-Speed Human Temporal Bone Sectioning for the Assessment of COVID-19-Associated Middle Ear Pathology
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[Bilateral temporal bone xanthoma associated with hyperlipidemia].

M V Subbotina1, O V Kanya2

  • 1Irkutsk State Medical University, Department of Otorhinolaryngology, Irkutsk, Russia.

Vestnik Otorinolaringologii
|June 2, 2020
PubMed
Summary

This clinical observation highlights a rare case of bilateral temporal bone xanthoma, initially misdiagnosed as chronic otitis media. Early detection of hyperlipidemia is crucial for managing this condition.

Keywords:
differential diagnosis of mastoiditishypercholesterolemiatemporal bone xanthoma

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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.