Otoscleroma of the Middle Ear and Mastoid Cavity with Facial Palsy: A Case Report

Scleroma is a chronic, specific granulomatous disease that affects the head and neck mucosa. Its common sites are the nose and larynx; however, it might affect other areas. One of the rare sites to be affected is the middle ear and mastoid cavity, for which the term otoscleroma was coined. We present such a rare case in this report.

A 47-year-old patient with a history of both old laryngoscleroma and recent Rhinoscleroma. He presented with symptoms of ear discharge and facial palsy. Examination revealed complete facial nerve palsy and an external auditory canal polyp. A decision was made to perform subtotal petrosectomy with facial nerve decompression and maximum debulking to be sent for histopathology. The result came typical of otoscleroma.

Otoscleroma is a fairly rare occurrence. It might be primary, with no evidence of Scleroma in other sites or following rhino and/or laryngoscleroma. It might be unilateral or bilateral. It might mimic the clinical picture of chronic suppurative otitis media and its complications. Tympano-mastoidectomy is recommended to stop the discharge, obtain a proper biopsy and decompress the facial nerve if needed. Otoscleroma should be suspected in the case of previous Scleroma in other sites, and otitis media or complications like manifestations.