Middle ear myxoma: a diagnostic dilemma and its management, a case report
Abstract The aim of this study was to present a rare case report of myxoma of the mastoid cleft/temporal bone with intracranial extension and its management and follow-up. A 13-year-old girl presented with discharge from the right ear with gradually progressive hearing loss for the last 4–5 years an...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2018-11-01
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| Series: | The Egyptian Journal of Otolaryngology |
| Online Access: | http://link.springer.com/article/10.4103/1012-5574.244901 |
| _version_ | 1797203778951184384 |
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| author | Santanu Dutta Prasanta K. Gure Sudipta Pal Somnath Saha |
| author_facet | Santanu Dutta Prasanta K. Gure Sudipta Pal Somnath Saha |
| author_sort | Santanu Dutta |
| collection | DOAJ |
| description | Abstract The aim of this study was to present a rare case report of myxoma of the mastoid cleft/temporal bone with intracranial extension and its management and follow-up. A 13-year-old girl presented with discharge from the right ear with gradually progressive hearing loss for the last 4–5 years and facial palsy of grade III on the right side for the last 4–5 months. She was diagnosed as having chronic otitis media, squamosal type, and underwent canal wall down mastoidectomy on the same ear 6 months back. On examination, an aural polyp occupying the whole of the mastoid cavity along with mucopurulent discharge and lower motor neuron facial palsy were seen on the right side. high resolution ct scan (HRCT) of the temporal bone showed a soft tissue mass occupying the whole of the mastoid cavity breaching bony confinements, extending up to the posterior fossa, extradurally, and engulfing the facial nerve. The patient underwent reexploration of the right mastoid cavity under general anaesthesia and a soft jelly-like substance was removed from whole of the mastoid cavity, extending anteriorly up to the Eustachian tube, inferiorly up to the jugular bulb, posteriorly up to the retrosigmoid cells, superiorly up to the tegmen plate, extending medially intracranially up to the posterior fossa dura through Trautmann’s triangle and engulfing the facial nerve from the first genu to the stylomastoid foramen. Facial nerve decompression was performed along with disease clearance and wide conchomeatoplasty. The patient developed grade IV facial palsy postoperatively. The histopathology report of the dissected jelly-like soft tissue revealed myxoma. The patient is at present under regular follow-up and there is no recurrence after 6 months, although facial palsy is still persisting as grade IV. Myxoma of the temporal bone or the mastoid cleft is a rare entity. Complete surgical excision is the treatment of choice in this case, although recurrence is very common. The clinical presentation, management and outcome of this tumour are discussed in view of available literature. |
| first_indexed | 2024-04-24T08:24:45Z |
| format | Article |
| id | doaj.art-6840fb69fd064d33af567074c2082d06 |
| institution | Directory Open Access Journal |
| issn | 1012-5574 2090-8539 |
| language | English |
| last_indexed | 2024-04-24T08:24:45Z |
| publishDate | 2018-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Otolaryngology |
| spelling | doaj.art-6840fb69fd064d33af567074c2082d062024-04-16T23:12:52ZengSpringerOpenThe Egyptian Journal of Otolaryngology1012-55742090-85392018-11-0134435135410.4103/1012-5574.244901Middle ear myxoma: a diagnostic dilemma and its management, a case reportSantanu Dutta0Prasanta K. Gure1Sudipta Pal2Somnath Saha3Department of ENT, Head and Neck Surgery, R. G. Kar Medical College and HospitalDepartment of ENT, Head and Neck Surgery, North Bengal Medical College HospitalDepartment of ENT, Head and Neck Surgery, National Medical College and HospitalDepartment of ENT, Head and Neck Surgery, NRS Medical College and HospitalAbstract The aim of this study was to present a rare case report of myxoma of the mastoid cleft/temporal bone with intracranial extension and its management and follow-up. A 13-year-old girl presented with discharge from the right ear with gradually progressive hearing loss for the last 4–5 years and facial palsy of grade III on the right side for the last 4–5 months. She was diagnosed as having chronic otitis media, squamosal type, and underwent canal wall down mastoidectomy on the same ear 6 months back. On examination, an aural polyp occupying the whole of the mastoid cavity along with mucopurulent discharge and lower motor neuron facial palsy were seen on the right side. high resolution ct scan (HRCT) of the temporal bone showed a soft tissue mass occupying the whole of the mastoid cavity breaching bony confinements, extending up to the posterior fossa, extradurally, and engulfing the facial nerve. The patient underwent reexploration of the right mastoid cavity under general anaesthesia and a soft jelly-like substance was removed from whole of the mastoid cavity, extending anteriorly up to the Eustachian tube, inferiorly up to the jugular bulb, posteriorly up to the retrosigmoid cells, superiorly up to the tegmen plate, extending medially intracranially up to the posterior fossa dura through Trautmann’s triangle and engulfing the facial nerve from the first genu to the stylomastoid foramen. Facial nerve decompression was performed along with disease clearance and wide conchomeatoplasty. The patient developed grade IV facial palsy postoperatively. The histopathology report of the dissected jelly-like soft tissue revealed myxoma. The patient is at present under regular follow-up and there is no recurrence after 6 months, although facial palsy is still persisting as grade IV. Myxoma of the temporal bone or the mastoid cleft is a rare entity. Complete surgical excision is the treatment of choice in this case, although recurrence is very common. The clinical presentation, management and outcome of this tumour are discussed in view of available literature.http://link.springer.com/article/10.4103/1012-5574.244901 |
| spellingShingle | Santanu Dutta Prasanta K. Gure Sudipta Pal Somnath Saha Middle ear myxoma: a diagnostic dilemma and its management, a case report The Egyptian Journal of Otolaryngology |
| title | Middle ear myxoma: a diagnostic dilemma and its management, a case report |
| title_full | Middle ear myxoma: a diagnostic dilemma and its management, a case report |
| title_fullStr | Middle ear myxoma: a diagnostic dilemma and its management, a case report |
| title_full_unstemmed | Middle ear myxoma: a diagnostic dilemma and its management, a case report |
| title_short | Middle ear myxoma: a diagnostic dilemma and its management, a case report |
| title_sort | middle ear myxoma a diagnostic dilemma and its management a case report |
| url | http://link.springer.com/article/10.4103/1012-5574.244901 |
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