gms | German Medical Science

Introduction: Glomus tympanicum tumors (tympanic paragangliomas) and hemangioma of the middle ear are very rare events in children. Typical clinical symptoms are a conductive hearing loss and a suppurative draining.

Case report: After 18 month ineffectively treating a draining ear of a five years old mentally retarded girl with different local and systemic antibiotics she was handled in-patient under suspicion of a mastoiditis. Clinical examination showed a swollen outer ear canal and a smelling secretion. A high definition CT-scan of the temporal bone revealed an inflammatory process of tympanum and mastoid. By audiogram a conductive hearing loss of 40dB was determined. A mastoidectomy had been performed. During operation no purulent but clear secretion could be drained. The complete tympanic cavity was filled with easily bleeding tissue. A paracentesis had been waived because of the persisting swelling of the outer ear canal. A MR-angiography had been performed for that reason. It showed a mesotympanal, highly vascularized tumor suspecting a glomus tympanicum tumor.

Because of very small vessels in the tumor the embolisation could have been neglected Operative extirpation of the vascular tumor followed by a type III tympanoplasty succeeded hassle-free. Histological diagnostics assessed the tissue as capillary hemangioma. A tympanic paraganglioma could not be witnessed. Postoperatively a complete healing of the middle resulted.