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Middle ear tumors

Benign tumors of the middle ear. Benign tumors include fibroma and angioma (with relatively slow growth, recurrent bleeding), endothelioma, osteoma (mastoid process), osteoblastoma of the mastoid process and pyramid. True cholesteatoma is rarely found in the area of ​​the temporal bone scales, in the mastoid process, sometimes with spread to the tympanic cavity and cranial fossa with crushing of the brain. The true (primary) cholesteatoma is a tumor-like malformation - epidermoid. It forms a cavity with smooth walls in the bone, and secondary cholesteatoma with chronic epithympanitis gives processes to the pneumatic cells of the mastoid process. Due to the frequent combination of true cholesteatoma with chronic purulent otitis media, a differential diagnosis with cholesteatoma of chronic epithympanitis is difficult. Chroma of the temporal bone is a manifestation of leukemia.

Malignant tumors of the middle ear. Middle ear epithelial cancer is less common than in the outer ear. Often, it develops against a background of chronic suppurative otitis media, complicated by polyps and granulations. The age of patients is 50-60 years. More often squamous, highly differentiated, keratinizing, less often adenocarcinoma, cylindroma and transitional cancer are observed.

Adenocarcinoma originates from the sulfur glands, the parotid gland and the glands of the mucous membrane of the tympanum. The cylinder of the middle ear is formed from the tubular region, hypothympanum and the anterior wall of the tympanum.

Cancer of the middle ear has two forms: petromastoid (tympanic cavity, antrum with involvement of the external auditory canal) and tympanotubic (with spread to the external auditory canal).

An early sign of cancer is hearing loss and suppuration, with the appearance of purulent-bloody fetid discharge, dense polyps, bleeding granulations. Patients take this for chronic purulent otitis media and often go to the doctor only for severe headaches, earaches, dizziness, increasing hearing loss and paralysis of the facial nerve. Paralysis of IX-XII cranial nerves and Horner's syndrome are frequent with tumor growth to the jugular opening. The tumor can spread in all directions to the cranial cavity with damage to almost all cranial nerves, to the nasopharynx.

The primary tumors of the auditory tube are cylinders, often without previous chronic otitis media, and therefore are difficult to recognize.

There are 4 stages of middle ear cancer.

Stage I - the tumor captures the mucous membrane of the middle ear.

Stage II - a tumor in the form of papillomatosis of the region of the tympanic ring, exciting the bone.

Stage III - a large decaying tumor that extends beyond the compact layer of the middle ear bone, metastases to regional lymph nodes accessible to surgical removal.

Stage IV - an extensive decaying tumor with damage to the top of the pyramid of the temporal bone, spreading into the temporal fossa and nasopharynx. The presence of metastases in the deep lymph nodes of the neck, fused with the internal carotid artery, spine or distant metastases.

Cytology and biopsy contribute to diagnosis. X-ray of the temporal bones according to Schuller, Meyer, Stenvers and tomography are important in determining the spread of the tumor and destruction of the bones.

The differential diagnosis is carried out with chronic suppurative otitis media, glomus tumor, neuroma of the VIII nerve, fibrous dysplasia of the temporal bone.
Often a tumor is recognized late, in stages III-IV.

Combined treatment - surgical and radiation. An extended radical operation on the ear and subtotal resection of the temporal bone with additional removal of the affected tissue are performed.

Breast cancer, hypernephroma, prostate and thyroid cancer, bronchial cancer, which are often asymptomatic and are autopsy findings, can metastasize to the temporal bone.

Non-epithelial tumor - sarcoma is rare, mainly in young people, and affects the middle ear. It often occurs without previous chronic purulent otitis media; it grows rapidly towards the top of the pyramid, occipital bone, base of the skull. Hearing loss, spotting from the ear, peripheral paralysis of the facial nerve, ear pain are noted. Early metastases appear in the lungs, bones, etc. Sometimes sarcoma affects the outer and even less commonly the inner ear.

Radiation or combined treatment.

Neurogenic malignancies include very rare neurosarcoma, middle ear melanoma, chordoma, granulocytic sarcoma, chloroma, and eosinophilic granuloma.

Chordoma grows from the base of the skull to the pyramid, the lateral cistern of the bridge and causes the corresponding symptoms. The diagnosis is made when a tumor invades the middle ear or external auditory meatus using a biopsy. Radiologically determined destruction of the top of the pyramid and Blumenbach stingray.

Combined treatment.

Granulocytic sarcoma is very rare. It affects the temporal bone, sometimes with the nasopharynx, orbit and nasal cavity.

Chloroma is observed mainly in boys under 15 years of age. It has a destructive growth, gives metastases to the liver, kidneys, lungs, heart, lymph nodes, thyroid and goiter glands. Clinically proceeds as acute leukemia. Ear pain, suppuration of green color and hearing loss are noted. It spreads over the bones to all parts of the ear. The disease lasts up to several months with a fatal outcome. Diagnosed on the basis of the clinic and histological examination.

Treatment - radiation therapy, chemotherapy.

Eosinophilic granuloma is not a true tumor, but reticuloendotheliosis (a manifestation of hysteocytosis). A rare disease. Some authors attribute it to tumors. It proceeds as a focal osteomyelitis bone process with localization in the cranial vault (usually the frontal bone), ribs, long tubular bones, and pelvic bones. The temporal bone is its favorite localization. It is more common in children and young people. With multiple lesions, the prognosis is poor. There is suppuration of their ear, granulation, polyps in the ear canal, hearing loss, often paresis of the facial nerve, swelling around the auricle, sometimes fistula, symptoms of damage to the inner ear. In the mastoid process or scales of the temporal bone, a bone defect without reactive sclerosis is determined radiologically. The entire pyramid can be destroyed with damage to the corresponding cranial nerves. Diagnosis is by biopsy.

Treatment. Radical surgery and radiation therapy. During the operation, yellow-brown granulations with exposure of the dura mater, sigmoid sinus and facial nerve are often detected.
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Middle ear tumors

  1. Middle ear chronic inflammation
    Causes Acute purulent otitis media of the middle ear, suffered from acute respiratory viral infections, scarlet fever, tonsillitis, measles, diseases of the upper respiratory tract, middle ear injury. Symptoms Frequent profuse suppuration from the ear with an unpleasant odor, hearing loss, periodic exacerbations of inflammation in the middle ear. Often, cholesteatom masses are released from the ear. Possible increase in temperature. First Aid Alcohol
  2. MIDDLE EAR DISEASES
    Middle ear diseases represent the most clinically and socially important group. They often get sick adults and especially children. The result of these diseases is hearing loss, leading to a decrease in social activity, professional suitability and degree of fitness for military service. Finally, middle ear diseases can cause intracranial complications, which threaten fatal
  3. Middle ear disease
    Middle ear diseases are considered very common in all age groups, especially in childhood. With an unfavorable course, these diseases often lead to a persistent decrease in hearing, sometimes reaching a sharp degree. Due to the anatomical and physiological connection of the middle ear with the inner one and its topographic proximity to the meninges, inflammatory processes in the middle ear can cause severe
  4. Middle ear anatomy
    The middle ear (auris media) consists of several communicating airways: the tympanic cavity (cavum tympani), the auditory tube (tuba auditiva), the cave entrance (aditus ad antrum), the cave (antrum) and the associated mastoid airways (cellulae mastoidea). Through the auditory tube, the middle ear communicates with the nasopharynx; under normal conditions it
  5. Inflammatory diseases of the middle ear
    Pathological processes that occur in various parts of the middle ear are very diverse. The polymorphism of pathogenesis depends on the characteristics of the anatomy and physiology of this organ, pathological agent, immunological condition, etc. Depending on the duration of the disease, acute and chronic processes are distinguished, in relation to the stages of inflammation - catarrhal, serous and purulent forms
  6. Middle Ear Tuberculosis
    Tuberculosis of the middle ear is rare, occurs when the infection spreads through the hematogenous route from some distant primary focus, most often from the lungs. This position, in particular, is confirmed by the occurrence, most often in early childhood, of a lesion of the mastoid process without previous inflammation in the tympanic cavity. An important role in the emergence and development
  7. Middle ear inflammation acute
    Cause Penetration of various microorganisms into the middle ear: staphylococci, streptococci, viruses and fungi. Most often, microorganisms penetrate the middle ear through the auditory tube, which can be facilitated by inflammatory processes in the nasal passage, paranasal sinuses, and nasopharynx. Infection in the middle ear can get through the external auditory canal when the tympanic membrane ruptures. At
  8. Acute inflammation of the middle ear (otitis media)
    The clinical picture Acute inflammation of the middle ear is more often observed in children (especially infants and young children). Pathogenic microorganisms enter the tympanum with acute rhinitis, adenoid growths, with influenza, measles, scarlet fever. Sharp or gradually increasing pain, congestion of the ear, noise in the ear, often turning into a sensation of pulsation, hearing loss, increase
  9. INFLAMMATION OF THE MIDDLE AND INNER EAR, Eustachitis
    Middle ear inflammation (otitis media) is rare in cats. Usually it develops as a complication of inflammation of the outer ear, as well as as a result of perforation of the eardrum, or traumatic damage to the temporal region. The cause of inflammation is most often an infection caused by hemolytic streptococci or staphylococci, usually penetrating the middle ear through the Eustachian
  10. COMPLICATIONS OF PURULENT DISEASES OF THE MIDDLE AND INNER EAR
    Nosological forms of purulent inflammation of the middle ear are acute purulent otitis media, mastoiditis, chronic purulent epithympanitis, mesotympanitis and purulent labyrinthitis. With their unfavorable course, limited purulent processes can develop in neighboring anatomical areas (abscesses), diffuse inflammation of the meninges (meningitis) and brain matter (encephalitis), as well as
  11. Benign ear tumors
    Ear tumors are rare diseases. There are benign and malignant neoplasms. Benign ear tumors include papillomas, fibromas, angiomas, chondromas, osteomas, etc. Of the tumor-like formations, various cysts (atheromas, dermoids, etc.) should be noted. Benign tumors are localized mainly in the outer ear.
  12. Malignant tumors of the ear
    Malignant tumors of the ear can be both primary, i.e. developed directly in a particular department of the ear, and arising from the germination of tumors from neighboring organs and tissues. In the outer and middle ear, cancer is more often diagnosed in adults, and sarcoma in children. Of the other species, there may be melanoma. The course of tumors of the outer ear is relatively slow, they look like
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