Middle ear hemangioma
Last reviewed: 23.04.2024
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Middle ear hemangiomas - is an ear disease characterized by the development of angiomatous formations from the vessels of the mucous membrane of the tympanic cavity and their spread to the surrounding tissues, accompanied by their atrophy through pressure and various functional impairment.
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Symptoms of middle ear hemangioma
Symptoms of the middle ear hemangioma depend on the size of the tumor and its spread. Usually, this is a conductive type of hearing loss, with pressure on the medial wall of the tympanic cavity and its uzurah, a perceptual type of hearing loss and symptoms of vestibular dysfunction (dizziness, spontaneous nystagmus, vestibule-vegetative symptoms) are attached. The destruction of the medial wall of the tympanic cavity, as in the case of a glomus tumor, leads to paralysis of the facial nerve, and the exit of the hemangioma to the region of MMU and the lateral tank of the brain - to the nerves of the sulcus-face bundle and caudal group. In these signs, there is much in common with the glomus tumor, the difference lies in the absence of pulsating noise in the ear and the appearance of bleeding fleshy tissues and otorrhea in the external auditory canal.
Diagnosis of middle ear hemangioma
Diagnosis of the middle ear hemangioma is based on clinical signs and otoscopy data, in which a pale pink education that does not destroy it appears through the thinned eardrum. The middle ear hemangioma is diagnosed using angiography techniques, in which the vascular phase indicates the size of the vessels involved in the formation of a tumor, and the tissue phase indicates its prevalence. The value of this method lies in the fact that according to its results it is possible to plan the volume of surgical intervention and predict its result. The methods of radiography, CT and MRI are also applicable.
Histological examination can determine morphological structures characteristic of the capillary (most often), cavernous, branchy arterial or branchy venous hemangioma, or hemangioepithelioma.
Treatment of middle ear hemangioma
Treatment of the middle ear hemangioma may include various methods: direct effects on the tumor tissue through radiotherapy, obliteration of the tumor by injecting sclerosing agents into the nose; tumor destruction by thermocoagulation or exposure to a carbon dioxide laser and surgical removal. The latter may include non-operative methods (ligation of supply vessels) and radical - by total curettage of the tumor, followed by diathermocoagulation of the remaining islets. Before radical surgery, the external carotid artery is ligated and the provisional ligature is applied to the common carotid artery.
What is the prognosis for middle ear hemangioma?
Uncommon middle ear hemangioma usually has a favorable prognosis; with extensive hemangiomas spreading in a single block in the direction of the MMU, to the base of the skull and sphenoid bone with damage to the walls of its sinuses - serious. In such cases, the treatment of hemangiomas of the middle ear is divided into several stages: preparatory and intermediate. The preparatory period may include the ligation of the external carotid artery, deep radiotherapy, the introduction of sclerosing chemotherapy; Follow-up treatment may include the gradual removal of a tumor with an assessment of the results of each of the surgical procedures performed by angiography with the possibility of temporary or permanent cessation of therapeutic measures in the absence of relapse and significant disturbing patient discomforts (pain). Often, surgical treatment of hemangioma of the middle ear and other methods lead to exacerbation of hearing loss, the appearance of paresis or paralysis of the facial and other nerves. These costs of therapy have to be put up with in favor of achieving the main result - the cessation of the spread of the tumor in the vital areas of the skull, nasopharynx and neck.