Hemangioma of the middle ear

Hemangiomas of the middle ear are 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 due to pressure and various functional disorders.

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Symptoms of middle ear hemangioma

Symptoms of middle ear hemangioma depend on the size of the tumor and its spread. Usually, it is a conductive type of hearing loss, with pressure on the medial wall of the tympanic cavity and its erosions, a perceptive type of hearing loss and symptoms of vestibular dysfunction (dizziness, spontaneous nystagmus, vestibulo-vegetative symptoms) are added. Destruction of the medial wall of the tympanic cavity, as with a glomus tumor, leads to paralysis of the facial nerve, and the exit of the hemangioma into the area of the MMU and the lateral cistern of the brain - to damage to the nerves of the auditory-facial bundle and the caudal group. The above signs have much in common with a glomus tumor, the difference is the absence of pulsating noise in the ear and the appearance of bleeding fleshy tissues and otorrhea in the external auditory canal.

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Diagnosis of hemangioma of the middle ear

Diagnosis of middle ear hemangioma is based on clinical signs and otoscopy data, in which a pale pink formation shines through the thinned eardrum without destroying it. Middle ear hemangioma is diagnosed using angiography methods, in which the vascular phase indicates the size of the vessels involved in the formation of the tumor, and the tissue phase indicates its prevalence. The value of this method is that its results can be used to plan the extent of surgical intervention and predict its outcome. X-ray, CT and MRI methods are also applicable.

Histological examination may reveal morphological structures characteristic of capillary (most common), cavernous, branched arterial or branched venous hemangioma, or hemangioepithelioma.

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Treatment of hemangioma of the middle ear

Treatment of middle ear hemangioma may include various methods: direct action on tumor tissues by means of radiotherapy, tumor obliteration by introducing sclerosing agents into the nose; tumor destruction by thermocoagulation or carbon dioxide laser exposure, and surgical removal. The latter may include non-surgical methods (ligation of feeding vessels) and radical ones - by total curettage of the tumor with subsequent diathermocoagulation of the remaining islets. Before radical surgical intervention, the external carotid artery is ligated and a provisional ligature is applied to the common carotid artery.

What is the prognosis for middle ear hemangioma?

An uncommon hemangioma of the middle ear usually has a favorable prognosis; in case of extensive hemangiomas spreading as a single block in the direction of the middle ear, to the base of the skull and sphenoid bone with damage to the walls of its sinuses - serious. In such cases, the treatment of hemangioma of the middle ear is divided into several stages: preparatory and intermediate. The preparatory period may include ligation of the external carotid artery, deep X-ray therapy, administration of sclerosing chemotherapy drugs; subsequent treatment may include step-by-step removal of the tumor with an assessment of the results of each of the surgical interventions performed by angiography with the possibility of temporary or permanent cessation of treatment in the absence of relapse and significant disturbances that bother the patient (pain). Often, surgical treatment of hemangioma of the middle ear and other methods lead to worsening hearing loss, paresis or paralysis of the facial and other nerves. These costs of therapy must be put up with in order to achieve the main result - stopping the spread of the tumor into vital areas of the skull, nasopharynx and neck.