Intra Operative Middle Ear Surprise Presenting with Unilateral Conductive Hearing Loss in an Intact Ear Drum - An Interesting Case Report

Sanjeev Mohanty, Ansiya Abbas Ali, Deepthi Padmanabhan, Gunakeerthana Ramesh, Balaj Kumaragurubaran

Abstract: Middle ear masses are relatively uncommon, and endoscopic techniques are increasingly favoured over traditional surgical methods for examining the middle ear. This report details a case involving a 41 - year - old female who experienced a sensation of blockage in her right ear. On examination, the right tympanic membrane appeared intact but was bulging. Audiometric tests confirmed moderate conductive hearing loss in the right ear. Radiological studies revealed a soft tissue mass in the right middle ear and mastoid air cells. During middle ear exploration under general anaesthesia, a smooth, pale, non - pulsatile sessile mass was identified and successfully excised. Histopathological analysis of the mass showed polypoidal severe acute inflammatory granulation tissue with fibrinous exudates. This case underscores the importance of exploratory tympanotomy for direct diagnosis and management, highlighting its crucial role in addressing complex middle ear conditions when conservative methods fall short.

Keywords: Middle ear, Exploratory tympanotomy, Unilateral conductive hearing loss, Granulation tissue