Wednesday, September 19, 2012

Aural Polyp- CT

20 yr old  male with clinically aural polyp , on  CT shows a  , large, expansile,  subtly destructive , Soft tissue density lesion with stippled areas of hyperdensity, involving External Auditory canal  with extension to middle ear and partial resorption of ossicles , suggesting, associated cholesteatoma along with aural polyp.

Teaching points by Dr MGK Murthy.

·         Benign soft issue tumors of EAC include  aural polyp, lipoma, hemangioma,  arteriovenous malformations,  lymphangioma, leiomyoma, myxoma and neural tumors like schwannoma, glandular  tumors like ceruminoma or pleomorphic adenoma. Aural polyps are  a result of chronic inflammation and elicit usually no bone resorption or destruction. Biopsy is mandatory as they can mimic squamous or basal cell carcinomas. High rate of underlying cholesteatoma(52%)
·         CT would help in assessing  the extent and surgical planning needed.    In children Suppurative otitis media  (SOM),broken tympanostomy tubes, Langerhans cell histiocytosis, and mycobacterial infection  could predispose to polyp formatio.  Treatment depends on underlying cause which needs therapy

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