Multiple Osteomas of Eustachian Tube Causing Ipsilateral Otitis Media

Abstract

Background: Middle ear ventilation and the drainage of secretions are the basic functions of the eustachian tube. Eustachian tube (ET) dysfunction can lead to otitis media. Multiple causes of ET dysfunction exist. ET obstruction is one of them. Osseous obliteration of ET is quite rare. In the literature, there are two cases of solitary osteoma and a case of hamartoma with an osseous content in the ET. Herein, this report describes the case of a patient with multiple osseous lesions consistent with osteomas in the ET, causing ipsilateral otitis media with CT findings. Case Report: 53-year-old woman presented with left-sided intermittent otalgia and otorrhea. Temporal bone computed tomography showed opasification middle ear consistent with otitis media and nearly completely blocking the left ET lumen with multiple osseous lesions wall probably consistent with osteomas on the left side. Conclusion: There are limited data about the radiological features of ET osteomas due to its rarity. Radiographically, external ear osteoma generally appears as a singlepedunculated hyperdense mass on CT scan originating from the tympanosquamous or tympanomastoid suture line and extending into the auditory canal with otherwise preserved canal dimensions. Considering this information, osseous lesions arising from ET bone wall and extending into the lumen in present case was considered as osteomas. Especially in case of unilateral chronic otitis media, ET should not remain a neglected anatomical area.

Osteoma de trompa de Eustaquio

“…El osteoma aislado de la trompa de Eustaquio es una entidad extremadamente rara, la cual produce disfunción de la trompa [6]. Esta disfunción conlleva a que por retracción de la membrana timpánica se pueda fijar la cadena osicular, lo cual produce hipoacusia, síntoma inicial según la literatura en osteomas que afecten el oído medio, presentándose esta en un 72% de los pacientes con osteoma en el oído medio [1,5].…”

“…La obstrucción mecánica que produce el osteoma impidiendo el adecuado drenaje del oído medio puede producir otitis medias a repetición. Nuestra revisión únicamente reveló tres casos comprobados de osteoma aislado en trompa de Falopio, los cuales fueron reportados en 1956, 1976 y 2020 [6].…”

Diagnosis and Management of Craniofacial Osteomas

“…Large osteomas can also lead to asymmetry of the facial bones 59 . Although rarely reported, osteomas of the external auditory canal and Eustachian tube of the temporal bone have presented with intermittent otalgia, 61 otorrhea, 61 overlying swelling of the mastoid bone, 62 progressive hearing loss, 21,63,64 and aural fullness 21,65 …”

“…58 Large osteomas can also lead to asymmetry of the facial bones. 59 Although rarely reported, osteomas of the external auditory canal and Eustachian tube of the temporal bone have presented with intermittent otalgia, 61 otorrhea, 61 overlying swelling of the mastoid bone, 62 progressive hearing loss, 21,63,64 and aural fullness. 21,65 Involvement of the paranasal sinuses (frontal, maxillary, ethmoid, and sphenoid) can lead to various symptoms depending on the occlusion of the sinus outflow tracts.…”