Middle ear tumors

There are a range of middle ear tumors, which are more likely to be benign than malignant.

Pathology

The three most common middle ear tumors are (not in any particular order as there are differences in the literature) :

• glomus tympanicum paraganglioma
• congenital cholesteatoma
• middle ear schwannoma
  • most commonly arising from the facial nerve but can also arise from the Jacobson nerve, chorda tympani or the Arnold nerve 

Other rarer middle ear tumors include

• middle ear adenoma
• middle ear rhabdomyosarcoma

Differential diagnosis

If large, these can be difficult to distinguish from direct extension into the middle ear of

• external acoustic meatus malignancies (e.g. squamous or basal cell carcinoma)
• nasopharyngeal carcinoma
• parotid gland neoplasms
• schwannomas originating from outside the middle ear

Additionally, aggressive infections (e.g. malignant otitis externa, tuberculous otomastoiditis, Aspergillus) can appear similar.