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Case Reports
. 2024 Sep 25:12:2050313X241286689.
doi: 10.1177/2050313X241286689. eCollection 2024.

Destructive foreign body granuloma: A case report

Pithiwat Wongwan  1 , Sarun Prakairungthong  2 , Suvajana Atipas  2 , Kanthong Thongyai  2 , Siriporn Limviriyakul  2 , Kanokrat Suvarnsit  2
Affiliations
Case Reports

Destructive foreign body granuloma: A case report

Pithiwat Wongwan et al. SAGE Open Med Case Rep. .

Abstract

External auditory canal polyps are predominantly inflammatory processes but occasionally indicate more severe pathology. Prolonged conservative management may postpone accurate diagnosis and appropriate therapeutic intervention. This case report presents a 37-year-old woman, previously healthy with a normal ear, who underwent a right myringotomy with the insertion of a pressure-equalizing tube in one hospital after an upper respiratory tract infection. However, due to the pandemic era, she lost follow-up for 2 years and subsequently presented to another hospital with worsening hearing and persistent otorrhea. The attending physician found a large polypoid lesion occupying her right external ear canal. A computerized tomography scan revealed an irregular enhancement mass involving the right ear canal, the middle ear cavity, and mastoid air cells with multiple destruction of the skull base and intracranial involvement in the right middle cranial fossa. The possibility of malignancy was raised, prompting the patient to seek evaluation in a third hospital. A right tympanomastoidectomy was performed, and during a posterior tympanotomy, a pressure-equalizing tube was discovered in her middle ear. The pathological results confirmed the presence of foreign body granuloma. Following surgery, the patient's otorrhea improved.

Keywords: Foreign body; aural polyps; chronic otitis media; middle ear; pressure-equalizing tube.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Audiometry revealed profound right sensorineural hearing loss.
Figure 2.
Figure 2.
(a) A temporal bone computed tomography (CT) scan axial view showed an irregular enhancing mass involving the right ear canal, the middle ear cavity, and mastoid air cells (arrow). (b) A temporal bone CT scan axial view showed multiple destruction of the skull base and intracranial involvement in the right middle cranial fossa (star).
Figure 3.
Figure 3.
Granulation tissue occluded the right mastoid antrum (arrow).
Figure 4.
Figure 4.
(a) Pressure-equalizing tube (black arrow) located in the right middle ear. (Star: mastoid antrum, white arrow: posterior tympanotomy). (b) Pressure-equalizing tube located in the right middle ear.
See this image and copyright information in PMC

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