Figure 3.33 The audiogram shows the presence of significant ipsilateral conductive hearing loss.

Adenoma Middle Ear
Figure 3.34 The CT scan demonstrates a soft-tissue mass occupying the middle ear with extrusion through the tympanic membrane.
Masses Middle Ear

Figure 3.35 CT scan, axial view. Presence of glue in the mastoid cells without erosion of the intercellular septae.


Carcinoid tumors of the middle ear are very rare. They are considered a subgroup of the adenomatous tumors of the middle ear. Clinically, they manifest as hearing loss, tinnitus, aural fullness, facial nerve paresis, vertigo, and otalgia. These tumors require a functional surgery that entails removal of the tympanic membrane and ossicular chain together with the mass. The tympanic membrane is grafted at the same stage, whereas the ossicular chain is reconstructed at a second stage. This strategy ensures that the condition is completely cured.

Figure 3.35 CT scan, axial view. Presence of glue in the mastoid cells without erosion of the intercellular septae.

• Histiocytosis X

Histiocytosis X refers to a group of disorders of the reticuloendothelial system characterized by proliferation of cytologically benign histiocytes. The disease can present in three clinical forms, the most benign of which is eosinophilic granuloma, which is usually monostotic. A moderately aggressive form is known as Hand-Schiiller-Christian disease. It is characterized by multifocal lesions that are predominantly osteolyt-ic. The most severe form, Letterer-Siwe disease, occurs in children under 3 years of age and presents with diffuse multiorgan involvement. It has a mortality rate of about 40% despite therapy with cytotoxic drugs and corticosteroids. Survivors suffer from diseases such as diabetes insipidus, pulmonary fibrosis, and vertebral column involvement.

Letterer Siwe Disease Images

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