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Middle-ear lipoma as a cause of otomastoiditis
J L Edmonds1, J M Woodroof, G A Ator
1Department of Otolaryngology, University of Kansas, USA.
Insights
A rare middle-ear lipoma caused chronic ear issues in a child, despite treatment. This finding highlights lipomas as an unusual cause of eustachian tube dysfunction.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Surgical Pathology
Background:
- Eustachian tube dysfunction is a common clinical problem.
- Chronic otorrhea despite medical therapy and ventilation tubes can indicate underlying pathology.
- Rare middle ear masses can present as a cause of persistent eustachian tube dysfunction.
Observation:
- A seven-year-old child presented with chronic draining ears.
- Previous treatments including ventilation tubes were ineffective.
- A mass was identified in the middle ear during myringotomy.
Findings:
- A pedunculated lipoma originating from the anterior medial middle-ear cleft was discovered.
- The lipoma intermittently obstructed the eustachian tube orifice.
- This represents the fourth reported case of a middle-ear lipoma globally.
Implications:
- Middle ear lipomas should be considered in the differential diagnosis of refractory eustachian tube dysfunction.
- Further investigation into the etiology of middle ear lipomas is warranted.
- This case adds to the limited literature on middle ear lipomas and their clinical presentation.
Abstract:
We present a case report which describes a rare cause of a common clinical problem; eustachian tube dysfunction. A seven-year-old child presented with a history of chronic draining ears, despite rigorous medical therapy and multiple ventilation tubes. At myringotomy a mass was noted in the middle ear, and she was taken to the operating room for exploration. The patient was found to have a pedunculated lipoma arising from the anterior medial aspect of the middle-ear cleft producing intermittent obstruction of the eustachian tube orifice. This case represents the fourth case of a middle-ear lipoma in the world literature. We present a review of the literature and an exploration of possible aetiologies of this unusual entity in the differential diagnosis of eustachian tube dysfunction.