Myxoma
of the middle ear-a rare cause of facial palsy. HNO. 2006 Nov 18.
In case of
the co-occurrence of facial palsy and inflammation-like symptoms of
the same ear, the differential diagnosis is focused on viral (herpes
zoster) or bacterial diseases. We report a patient for whom the
surgical exploration of the middle ear revealed a benign tumor: a
myxoma. These neoplasias are rare tumors in the head and neck
region. The typical tumor site is the atrium of heart. In the ear,
the tumor grows slowly and remains asymptomatic unless it irritates
structures such as the facial nerve or the vestibular organ.
Histologically, the tumor presents a "myxoid" matrix that
is rich in acid mucopolysaccarides. The treatment of choice is
complete surgical resection. Using the case presented, we discuss
the causality between the tumor and the facial palsy, although
during the operation the bony canal of the nerve was found to be
intact. In any cases with clinically and radiologically unclear
findings of the ear in connection with facial palsy, surgical
exposure should be considered.
Audiovestibular
evolution in a patient undergoing surgical resection of a temporal
bone myxoma.
Primary
myxoma in the head and neck region occurs mostly in the maxilla and
mandible, and rarely in the temporal bone. A 32-year-old female
patient with temporal bone myxoma manifested as acute vertigo,
headache, and tinnitus on the right ear. Audiometry and auditory
brainstem response revealed normal responses, bilaterally.
Vestibular function test displayed spontaneous nystagmus beating
toward the left side. Absent ice water caloric response was
disclosed on the right ear, whereas vestibular evoked myogenic
potential test showed normal responses, bilaterally. MRI scan
demonstrated a well-enhanced mass at the anterior middle portion of
the right temporal bone with intracranial extension. Tumor excision
via craniotomy was performed, and the histopathological study
confirmed as myxoma. One year after operation, follow-up
audiovestibular function tests revealed normal responses, except for
23 dB conductive hearing loss on the right ear.
Ear myxomas in
Carney's complex. Plast Reconstr Surg.2005 Nov;116 (6):123e-124e.
Myxomas of the
external ear and their significance. Am J Surg Pathol. 1994
Mar;18(3):274-80.
Myxomas of
the external ear are extremely rare. We describe 27 such tumors in
22 of 152 patients with the complex of myxomas, spotty pigmentation,
endocrine tumors, and schwannomas--a familial (autosomal dominant)
syndrome. Eleven of the patients were male, and 11 were female; age
range was from birth to 41 years. Nine patients were members of
three affected families. The external auditory canal and the
external ear were involved in 18 and five patients, respectively; in
two, the exact ear location was not known. Three patients had both
ear canal and external ear lesions. Two patients with ear canal
myxomas had bilateral lesions. Six patients had recurrences after
simple excision. The ear canal lesions often were accompanied by
deafness due to occlusion of the canal; attachment to the canal wall
was usually by a pedicle. Grossly, the lesions were mucoid and from
3 mm to 2 cm in greatest dimension. Microscopically, they were
circumscribed but not encapsulated and were composed of scattered
stellate and spindle cells set in a myxoid, capillary-rich matrix.
An epithelial component (epidermal inclusion cysts or basaloid buds
or both) was present in 14 tumors. Cardiac myxoma occurred in nine
patients, Cushing's syndrome in three, and psammomatous melanotic
schwannoma in three. In two patients, the ear myxoma was the
presenting sign of the complex. Patients with myxoma of the external
ear (and their primary relatives) should be considered at risk for
the complex of myxomas, spotty pigmentation, endocrine tumors, and
schwannomas and should be examined accordingly.
Myxoma of the external auditory meatus. J Laryngol Otol.1991
May;105(5):364-6.
A case of
myxoma of the external auditory meatus is described. The patient
presented with a recurring tumour which had not been correctly
diagnosed although the growth had been removed ten times over a
period of two years. The tumour was skin covered, contained
gelatinous material and was attached to the tympanic membrane and
anterior canal wall. Following recognition of the tumour as myxoma,
removal was performed with sufficiently wide margins and there has
been no recurrence during follow-up for one year.
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