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Neurologist 2008-Jan

Transient facial palsy in two cases of benign, very rare middle ear tumors (carcinoid tumor and myxoma).

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Thorsten Zehlicke
Christoph Punke
Christoph Boltze
Hans Wilhelm Pau

Keywords

Abstract

OBJECTIVE

Presentation of the clinical features of 2 very rare middle ear tumors in which the guiding symptom was facial palsy.

METHODS

Illustrative case reports about a myxoma and a carcinoid tumor of the middle ear associated with peripheral facial palsy.

RESULTS

The facial palsy was transient in either case, and its pathomechanism is open for discussion. In both cases, the initial symptoms were typical for an inflammatory process. Moreover, both tumor entities are typically found in organs other than the ear; if located in the middle ear, those neoplasms grow rather superficially. In those cases, a surgical exposure of the middle ear is indicated.

CONCLUSIONS

The etiopathology of an acute peripheral facial palsy is often hard to identify. If the facial weakness starts together with symptoms suggesting an inflammatory process, the differential diagnosis may be focused first on diseases like herpes zoster oticus and a severe course of acute purulent otitis media. We report the cases of 2 rare middle ear tumors causing facial palsy. Treatment of choice should be complete surgical excision.

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