Rare middle ear papilloma

Recently, the Department of Otolaryngology and Head and Neck Surgery, Beijing Tsinghua Chang Gung Hospital affiliated to Tsinghua University successfully diagnosed and treated a case of middle ear papilloma, and the patient has recovered and been discharged from the hospital. The disease is a rare disease, and there are only more than 10 cases reported in the literature.

The patient is a 23-year-old boy with chronic Feeling stuffy and hearing loss, he went to Beijing Tsinghua Chang Gung Hospital Otolaryngology Head and Neck Surgery Clinic for treatment. After receiving the consultation, the attending physician Gao Juanjuan asked in detail the medical history and learned that the patient had undergone middle ear surgery in a foreign hospital in 2019 due to the same symptoms, and the postoperative symptoms were slightly relieved. After six months, the symptoms recurred quickly, but the patient did not seek treatment again. Recently, the patient developed symptoms of worsening hearing loss and ear discharge.

After careful physical examination, Gao Juanjuan found suspicious papilloma-like neoplasms in the middle ear of the patient. Combined with the CT examination of the temporal bone in the other hospital, Preliminarily judged that this was not an ordinary otitis media, but was most likely a middle ear tumor , after fully communicating with the patient, he consulted the chief physician of the department, Yi Haijin, and arranged hospitalization for the patient.

Combined with the patient’s complete examination after admission, Yihaijin organized case discussions for many times, and it was highly suspected that the patient was suffering from middle ear papilloma , the early symptoms of the disease are not typical, often manifested as ear fullness, hearing loss, etc. “It is very rare for this kind of tumor to originate in the middle ear, it is a benign tumor, but the primary lesions of the middle ear are The malignant transformation rate is high and needs timely treatment.” Yihaijin said.

According to Yi Haijin, the main purpose of surgery for this disease is to remove lesions and reduce recurrence. The patient in this case is relatively young and has high requirements for the quality of life. On the basis of fully removing the lesions, the chance of recurrence should be minimized and the patient’s facial nerve and auditory function should be preserved. For this reason, Yi Haijin led the team to formulate a detailed surgical plan :

Frozen pathology is sent during the operation. If the frozen pathology indicates benign, the selected surgical plan should preserve the hearing and vestibule as much as possible. and facial nerve function;

If the frozen pathology indicates malignancy, a more thorough surgical resection—subtotal temporal bone resection is required. At this time, the patient’s auditory function, vestibular function and facial nerve function may not be preserved.

The surgical team communicated repeatedly with the patients and their families to fully explain the condition, and the patients expressed their active cooperation with the surgical treatment.

With the support of Prof. In close collaboration, Yi Haijin, the chief surgeon, and resident physicians Gao Juanjuan and Wang Boyang, performed middle ear tumor resection + tympanoplasty for the patient under general anesthesia. The intraoperative frozen pathological results were judged by Yin Hongfang, director of the pathology department, finally confirmed the preoperative diagnosis – middle ear papilloma, which has not yet appeared malignant., so the surgical team Full excision of middle ear papilloma, including suspicious ossicles, tympanic membrane and part of tympanic lining mucosa, was performed, and hearing reconstruction was performed for the patient to ensure the postoperative quality of life of the patient as much as possible. After the operation, the patient had no obvious symptoms of dizziness, facial paralysis, and conscious hearing loss, and was discharged one week after the operation.

Source: Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University

Reprinted from: Beiqing Community News Tiantongyuan Edition< /span>

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