Malignant Mucosal Melanoma of the Eustachian Tube With Extension Into the Ipsilateral External Ear Canal: A Case Report and Review of the Literature

Mucosal melanoma arising in the middle ear or eustachian tube is uncommon. We present a patient with hearing loss and otalgia found to have mucosal melanoma which occurred in the eustachian tube with extension into the middle ear cavity and external ear canal. Otologic clinics was consulted and biopsy of the mass located at the external canal was performed to ascertain the pathological diagnosis. The patient refused immunotherapy and surgery instead of undergoing radiotherapy and died from hepatic metastasis 8 months later. The mucosal melanoma originated from the eustachian tube with extension into the external ear canal is exceedingly rare, and the differential diagnosis should be considered for tumors in external ear canal.

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Effects of Eustachian Tube Ligation on Auditory Nerve Responses to Clicks

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894780870s102 ◽

1978 ◽

Vol 87 (1_suppl) ◽

pp. 12-20 ◽

Cited By ~ 4

Author(s):

Michael L. Wiederhold ◽

Serge A. Martinez ◽

Robert E. C. Scott ◽

Hugh O. Defries

Keyword(s):

Hearing Loss ◽

Eustachian Tube ◽

Middle Ear ◽

Auditory Nerve ◽

External Ear ◽

Acoustic System ◽

Ear Canal ◽

Middle Ear Fluid ◽

Middle Ear Pressure ◽

Tube Ligation

Auditory nerve responses to condensation and rarefaction clicks were recorded from the external ear canal of cats using a closed acoustic system. Repeated control recordings from both ears formed a baseline for each of four animals used in this study. After a baseline had been established, the Eustachian tube on one side was ligated and serial recordings of N1 responses were performed for up to 140 days postligation. By comparing the shift which occurred in the N1 latency-vs-click level plots after ligation, the equivalent hearing loss was determined. In all cases where the Eustachian tube was successfully ligated, the loss was progressive for the first 20 days, then usually showed some transitory improvement. The loss stabilized after 60 days, varying from 15 to 40 dB in different animals. In addition to N1 recordings, serial tympanograms were also measured. These indicated negative middle ear pressure in the first two days postligation and the presence of middle ear fluid by one week postligation.

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Histopathology of the soft parts in 50 patients with malignant external otitis

The Journal of Laryngology & Otology ◽

10.1017/s0022215100108977 ◽

1989 ◽

Vol 103 (4) ◽

pp. 366-368 ◽

Cited By ~ 21

Author(s):

J. Bernheim ◽

J. Sade

Keyword(s):

Skin Lesions ◽

External Otitis ◽

Pathological Feature ◽

External Ear ◽

Ear Canal ◽

Malignant External Otitis ◽

External Ear Canal ◽

External Canal ◽

Skin Biopsies ◽

Skin Coverage

AbstractReports concerning the lesions of the skin coverage of the external ear canal in malignant external otitis (M.E.O.) are very few. To evaluate this problem, we studied the skin lesions of 45 skin biopsies from 40 M.E.O. patients, 23 from regions covering the osseous part of the ear structure, seven from the cartilaginous part of the external canal and 15 from both parts. The epidermis was normal in nine, thickened in 16, with acanthotic thickening and pseudoepitheliomatous hyperplasia in 20. In the dermis the amount of collagen was normal, but it was infiltrated by the inflammatory process. Acute inflammation was observed in 16 biopsies, subacute in 23, chronic in six. A mixture of acute and chronic changes was present in 18 biopsies. No major abnormalities of the vasculature could be detected. The distinguishing pathological feature of M.E.O. concerns the typical topographic distribution of the inflammation in the osseous part of the external ear canal.

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Chapter-12 Middle Ear Dissection and External Ear Canal Widening

Step by Step� Temporal Bone Dissection ◽

10.5005/jp/books/12134_12 ◽

2014 ◽

pp. 63-67

Author(s):

Gauri Belsare

Keyword(s):

Middle Ear ◽

External Ear ◽

Ear Canal ◽

External Ear Canal

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Side-Hole Suction for Ear Surgery

Otolaryngology ◽

10.1177/019459987908700121 ◽

1979 ◽

Vol 87 (1) ◽

pp. 87-88 ◽

Cited By ~ 2

Author(s):

N. Wendell Todd

Keyword(s):

Soft Tissue ◽

Middle Ear ◽

Surgical Trauma ◽

External Ear ◽

Ear Canal ◽

Ear Surgery ◽

Graft Placement ◽

Side Hole ◽

External Ear Canal

Surgical trauma to the soft tissue of the external ear canal and middle ear increases inflammation and scarring. A side-hole suction tip has been found to minimize suction-tip trauma, preclude the need to aspirate through synthetic sponge or cotton, and facilitate graft placement.

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External ear canal cholesteatoma after ventilation tube insertion and mastoidectomy

Vojnosanitetski pregled ◽

10.2298/vsp1204363d ◽

2012 ◽

Vol 69 (4) ◽

pp. 363-366 ◽

Cited By ~ 1

Author(s):

Dragoslava Djeric ◽

Milan Jovanovic ◽

Ivan Baljosevic ◽

Srbislav Blazic ◽

Milanko Milojevic

Keyword(s):

Tympanic Membrane ◽

Middle Ear ◽

Membrane Surface ◽

Tube Placement ◽

External Ear ◽

Ventilation Tube ◽

Ear Canal ◽

Tube Insertion ◽

Tissue Mass ◽

External Ear Canal

Introduction. Etiopathogenetically, there are two types of chollesteatomas: congenital, and acquired. Numerous theories in the literature try to explain the nature of the disease, however, the question about cholesteatomas remain still unanswered. The aim of the study was to present a case of external ear canal cholesteatoma (EEC) developed following microsurgery (ventilation tube insertion and mastoidectomy), as well as to point ant possible mechanisms if its development. Case report. A 16-yearold boy presented a 4-month sense of fullness in the ear and otalgia on the left side. A year before, mastoidectomy and posterior atticotomy were performed with ventilation tube placement due to acute purulent mastoiditis. Diagnosis was based on otoscopy examination, audiology and computed tomography (CT) findings. CT showed an obliterative soft-tissue mass completely filled the external ear canal with associated erosion of subjacent the bone. There were squamous epithelial links between the canal cholesteatoma and lateral tympanic membrane surface. They originated from the margins of tympanic membrane incision made for a ventilation tube (VT) insertion. The position of VT was good as well as the aeration of the middle ear cavity. The tympanic membrane was intact and of normal appearance without middle ear extension or mastoid involvement of cholesteatoma. Cholesteatoma and ventilation tube were both removed. The patient recovered without complications and shortly audiology revealed hearing improving. Follow-up 2 years later, however, showed no signs of the disease. Conclusion. There could be more than one potential delicate mechanism of developing EEC in the ear with VT insertion and mastoidectomy. It is necessary to perform routine otologic surveillance in all patients with tubes. Affected ear CT scan is very helpful in showing the extent of cholesteatoma and bony defects, which could not be assessed by otoscopic examination alone.

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Eustachian tube teratoma and its terminological correctness

The Journal of Laryngology & Otology ◽

10.1017/s0022215100143774 ◽

1999 ◽

Vol 113 (3) ◽

pp. 271-274 ◽

Cited By ~ 12

Author(s):

Carlos B. Ruah ◽

David Cohen ◽

Jacob Sadé

Keyword(s):

Germ Cell ◽

Eustachian Tube ◽

Middle Ear ◽

World Health ◽

External Ear ◽

Germ Cell Tumours ◽

Review Of The Literature ◽

New Classification ◽

Health Organization

AbstractTeratomas are germ cell tumours usually found in the young and are characteristically composed of tissue foreign to the place where they arise. Two teratomas of the middle ear were first described in 1866 and since then, and to the best of our knowledge, 19 additional cases have been reported in the literature under different terms such as hairy congenital polyps, epidermoid cysts, dermoid cysts, hamartoma, cutaneous teratoma and teratomas. The difficulty in classifying germ cell tumours may explain the different terminologies encountered in the literature. The authors describe a case of teratoma of the eustachian tube presenting as a mass in the middle and external ear of a 10-week-old girl. Using this case, a review of the literature is performed in light of the new classification of germ cell tumours proposed by the World Health Organization (WHO). It is of note that most of the teratomas that present in the middle ear arise from, or involve, the eustachian tube.

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Clinical study of carcinomas of external ear canal and middle ear.

Practica Oto-Rhino-Laryngologica ◽

10.5631/jibirin.82.555 ◽

1989 ◽

Vol 82 (4) ◽

pp. 555-562

Author(s):

Masaki Satoh ◽

Katsuhiko Tanaka ◽

Tadashi Yoshimura ◽

Noboru Sakai ◽

Hideyuki Ohnuma ◽

...

Keyword(s):

Clinical Study ◽

Middle Ear ◽

External Ear ◽

Ear Canal ◽

External Ear Canal

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Cochlear Implantation in Patients with Keratitis-Ichthyosis-Deafness Syndrome: A Report of Two Cases

Case Reports in Otolaryngology ◽

10.1155/2017/3913187 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

Birgul Gumus ◽

Armagan Incesulu ◽

Mehmet Ozgur Pinarbasli

Keyword(s):

Hearing Loss ◽

Hearing Aids ◽

Cochlear Implantation ◽

Pure Tone ◽

Pure Tone Audiometry ◽

External Ear ◽

Ear Canal ◽

External Ear Canal ◽

Brainstem Response ◽

Visual Disturbances

Background.Keratitis-ichthyosis-deafness (KID) syndrome is a syndrome which presents with hearing loss and visual and keratinization disorders. In such patients, hearing aids cannot be effectively used in the rehabilitation of hearing loss because of the frequent blockage of the external ear canal with epithelial debris and due to dry and tense skin of the external ear canal. Moreover, severe or profound hearing loss also limits the benefits gained from the conventional hearing aids. On the other hand, cochlear implantation is a method that has been used in limited cases in the literature.Case Report.This study presents the results of cochlear implantation applied in our clinic to two children who had been diagnosed with KID. Audiological assessments before and after the cochlear implant operation were performed using pure-tone audiometry, immittance audiometry, and auditory brainstem response (ABR), and the postoperative follow-up was conducted using pure-tone audiometry.Conclusion.Skin problems, visual disturbances, and other additional problems complicate the short-term and long-term rehabilitation after implantation in individuals with KID syndrome. Close monitoring should be exercised due to possible skin complications that may develop during the postoperative period. The families and rehabilitation teams should be warned about the possible visual disturbances and skin complications.

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