Osteoma of the Promontory Mimicking a Congenital Cholesteatoma

Abstract

Osteoma of the temporal bone most commonly occurs in the external ear. Osteomas in the middle ear are not common, and only 25 relevant cases (18 papers) have been reported in the English literature. With only 5 cases reported to date, osteoma of the promontory in the middle ear is rare. This study reports a case of asymptomatic osteoma of the promontory in the middle ear mimicking a congenital cholesteatoma in a 4-year-old girl.

Middle Ear Osteoma With Assimilation of Ossicles: An Unusual Case of Conductive Hearing Loss

“…Temporal bone osteomas are benign tumors typically found in the external auditory canal. Their occurrence within the middle ear is rare, though not unprecedented, with 39 cases documented since 1964 [1][2][3][4][5][6]. The etiology of middle ear osteomas is unclear.…”

“…Their location in the middle ear tends to dictate clinical presentation, which is typically a history of slow, progressive conductive hearing loss [8]. Occasionally the osteoma is visible through the TM and can be mistaken for a congenital cholesteatoma [4]. As a point of interest, several studies have noted a Carhart notch, which can lead to an incorrect diagnosis of otosclerosis if imaging is not performed [6,8,9].…”