Salivary Gland Choristoma of the Middle Ear and Review of the Literature

Serafín Sánchez Gómez, Juan Manuel Maza Solano, José Ramón Armas Padrón, Francisco Refolio Sánchez, Tomás Francisco Herrero Salado

Virgen Macarena University Hospital, Seville, Spain.

DOI: 10.4236/ijohns.2013.26045                

Abstract

Conductive hearing loss due to middle ear masses is uncommon and usually diagnosed after biopsy. We present a case of a permanent facial palsy occurred following an uneventful biopsy during an exploratory tympanotomy in a salivary gland choristoma of the middle ear. Most salivary gland choristomas have been found in the head and neck. Its location in the ear is extremely rare, and thus we present the 38th case in English and non-English literature from the first publication by Taylor in 1961. Complete surgical removal of salivary gland choristomas of the middle ear is indicated when may not result in permanent damage to the facial nerve. Only biopsy and observation are recommended when the mass is intimately associated with the facial nerve or there are unsafe facial nerve abnormalities. Although the facial nerve is involved in 40% of cases, transient or even permanent facial palsies are exceptional. The reactivation of latent herpes virus in the facial canal may be involved in facial palsy’ etiology following minimal and uneventful middle ear surgery like a biopsy rather than nerve injury related to facial canal malformations.

Keywords

Salivary Gland; Choristoma; Middle Ear; Facial Palsy; Herpesvirus Reactivation

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	A. Ferlito and K. O. Devaney, “Developmental Lesions of the Head and Neck. Terminololgy and Bio-Logical Behavior,” The Annals of Otology, Rhinology, and Laryngology, Vol. 104, 1995, pp. 913-918.
[2]	G. D. Taylor and H. F. Martin, “Salivary Gland Tissue in the Middle Ear: A Rare Tumor,” Archives of Otolaryngology, Vol. 73, 1961, pp. 651-653. http://dx.doi.org/10.1001/archotol.1961.00740020665006
[3]	N. Morimoto, K. Ogawa and J. Kanzaki, “Salivary Gland Choristoma in the Middle Ear: A Case Report,” American Journal of Otolaryngology, Vol. 20, No. 4, 1999, pp. 232-235. http://dx.doi.org/10.1016/S0196-0709(99)90005-4
[4]	B. P. Perry, R. L. Scher, L. Gray, E. H. Bossen and D. L. Tucci, “Pathologic Quiz Case 1. Salivary Gland Choristoma of the Middle Ear,” Archives of Otolaryngology— Head and Neck Surgery, Vol. 124, No. 6, 1998, pp. 714-716.
[5]	W. Anderhuber, A. Beham, C. Walch and H. Stammberger, “Choristoma of the Middle Ear,” European Archives of Oto-Rhino-Laryngology, Vol. 253, No. 3, 1996, pp. 182-184. http://dx.doi.org/10.1007/BF00615119
[6]	M. L. Hinni and C. W. Beatty, “Salivary Gland Choristoma of the Middle Ear: Report of a Case and Review of the Literature,” Ear, Nose & Throat Journal, Vol. 75, No. 7, 1996, pp. 422-424.
[7]	I. Namdar, E. E. Smouha and P. Kane, “Salivary Gland Choristoma of the Middle Ear: Role of Intraoperative Facial Nerve Monitoring,” Otolaryngology—Head and Neck Surgery, Vol. 112, No. 4, 1995, pp. 616-620.
[8]	H. Münster, “Salivary Gland Choristoma in the Middle Ear,” Ugeskr Laeger, Vol. 156, No. 31, 1994, pp. 4474-4475.
[9]	D. L. Cejas Méndez, J. L. de Serdio Arias and S. Goralsky Filonov, “Choristoma of the Salivary Gland and Dermoid Cyst of the Middle Ear in a 3 Year Old Girl. A Propos of a Case,” Nales Otorrinolaringologicos Iberoamericanos, Vol. 19, No. 3, 1992, pp. 275-282.
[10]	I. D. Bottrill, O. P. Chawla and A. D. Ramsay, “Salivary Gland Choristoma of the Middle Ear,” Journal of Laryngology & Otology, Vol. 106, No. 7, 1992, pp. 630-632. http://dx.doi.org/10.1017/S0022215100120389
[11]	P. J. Moore, B. N. Benjamin and A. E. Kan, “Salivary Gland Choristoma of the Middle Ear,” International Journal of Pediatric Otorhinolaryngology, Vol. 8, No. 1, 1984, pp. 91-95. http://dx.doi.org/10.1016/S0165-5876(84)80029-4
[12]	J. M. Kartush and M. D. Graham, “Salivary Gland Choristoma of the Middle Ear: A Case Report and Review of the Literature,” Laryngoscope, Vol. 94, No. 2, 1984, pp. 228-230.
[13]	K. L. Saeger, P. Gruskin and J. N. Carberry, “Salivary Gland Choristoma of the Middle Ear,” Archives of Pathology & Laboratory Medicine, Vol. 106, No. 1, 1982, pp. 39-40.
[14]	A. Quaranta, F. Mininni and L. Resta, “Salivary Gland Choristoma of the Middle Ear: a Case Report,” Journal of Laryngology & Otology, Vol. 95, No. 9, 1981, pp. 953-956. http://dx.doi.org/10.1017/S0022215100091660
[15]	C. R. Cannon, “Salivary Gland Choristoma of the Middle Ear,” American Journal of Otolaryngology, Vol. 1, No. 4, 1980, pp. 250-251.
[16]	H. A. Kley, “Middle Ear Choristoma,” Laryngologie, Rhinologie Otologie, Vol. 58, 1979, pp. 65-67.
[17]	R. E. Mischke, D. E. Brackmann and P. Gruskin, “Salivary Gland Choristoma of the Middle Ear,” Archives of Otolaryngology, Vol. 103, No. 7, 1977, pp. 432-434. http://dx.doi.org/10.1001/archotol.1977.00780240090016
[18]	C. J. Wine and J. E. Metcalf, “Salivary Gland Choristoma of the Middle Ear and Mastoid,” Archives of Otolaryngology, Vol. 103, No. 7, 1977, pp. 435-436. http://dx.doi.org/10.1001/archotol.1977.00780240093017
[19]	D. Hociotā and T. Ataman, “A Case of Salivary Gland Choristoma of the Middle Ear,” Journal of Laryngology & Otology, Vol. 89, No. 10, 1975, pp. 1065-1068. http://dx.doi.org/10.1017/S0022215100081378
[20]	R. C. Bruner, “Salivary Gland Choristoma of the Middle Ear. A Case Report,” Archives of Otolaryngology, Vol. 91, No. 3, 1970, p. 303. http://dx.doi.org/10.1001/archotol.1970.00770040409019
[21]	C. B. Caplinger and J. F. Hora, “Middle Ear Choristoma with Absent Oval Window: A Report of One Case,” Archives of Otolaryngology, Vol. 85, No. 4, 1967, pp. 365-366. http://dx.doi.org/10.1001/archotol.1967.00760040367004
[22]	T. N. Steffen and W. F. House, “Salivary Gland Choristoma of the Middle Ear,” Archives of Otolaryngology, Vol. 76, 1962, pp. 74-75. http://dx.doi.org/10.1001/archotol.1967.00760040367004
[23]	G. A. Braun, L. D. Lowry and A. Meyers, “Bilateral Choristomas of the External Auditory Canals,” Archives of Otolaryngology, Vol. 104, No. 8, 1978, pp. 467-470. http://dx.doi.org/10.1001/archotol.1978.00790080049013
[24]	M. Grosheva, C. Wittekindt and O. Guntinas-Lichius, “Prognostic Value of Electroneurography and Electromyography in Facial Palsy,” Laryngoscope, Vol. 118, No. 3, 2008, pp. 394-397. http://dx.doi.org/10.1097/MLG.0b013e31815d8e68
[25]	A. R. Tunkel, C. A. Glaser, K. C. Bloch, et al., “The Management of Encephalitis: Clinical Practice Guidelines by the Infectious Diseases Society of America,” Clinical Infectious Diseases, Vol. 47, No. 3, 2008, pp. 303-327. http://dx.doi.org/10.1086/589747
[26]	R. P. S. Harar, N. J. Eynon-Lewis, F. Scarivilli and G. B. Brookes, “Extensive Salivary Gland Choristoma of the Pterygopalatine Fossa,” Otolaryngology—Head and Neck Surgery, Vol. 122, No. 4, 2000, pp. 611-612. http://dx.doi.org/10.1016/S0194-5998(00)70114-8
[27]	A. Rinaldo, A. Ferlito and K. O. Devaney, “Salivary Gland Choristoma of the Middle Ear,” Journal for OtoRhino-Laryngology and Its Related Specialties, Vol. 66, No. 3, 2004, pp. 141-147. http://dx.doi.org/10.1159/000079334
[28]	S. Z. Toros, E. Egeli, Y. Kiliçarslan, G. Gümrükçü, T. Gökçeer and H. No§eri, “Salivary Gland Choristoma of the Middle Ear in a Child with Situs Inversus Totalis,” Auris Nasus Larynx, Vol. 37, No. 3, 2010, pp. 365-368. http://dx.doi.org/10.1016/j.anl.2009.09.003
[29]	M. Enoz and Y. Suoglu, “Salivary Gland Choristoma of the Middle Ear,” Laryngoscope, Vol. 116, No. 6, 2006, pp. 1033-1034. http://dx.doi.org/10.1097/01.mlg.0000217250.08455.d3
[30]	M. S. Boleas-Aguirre, S. Ernst, F. J. Cervera-Paz, A. Panizo and M. Manrique, “Salivary Gland Choristoma (Hamartoma) of the Middle Ear: A Case Report,” Revue de Laryngologie Otologie Rhinologie, Vol. 127, No. 4, 2006, pp. 247-249.
[31]	D. Yazici and F. Cetik, “An Infrequent Mass of the Middle Ear: Salivary Gland Choristoma,” Archives of Otolaryngology—Head and Neck Surgery, Vol. 132, No. 11, 2006, pp. 1260-1262. http://dx.doi.org/10.1001/archotol.132.11.1260
[32]	D. K. Lee, J. H. Kim, Y. S. Cho, W. H. Chung and S. H. Hong, “Salivary Gland Choristoma of the Middle Ear in an Infant: a Case Report,” International Journal of Pediatric Otorhinolaryngology, Vol. 70, No. 1, 2006, pp. 167-170. http://dx.doi.org/10.1016/j.ijporl.2005.05.030
[33]	P. Simoni, B. J. Wiatrak and D. R. Kelly, “Choristomatous Polyps of the Aural and Pharyngeal Regions: First Simultaneous Case,” International Journal of Pediatric Otorhinolaryngology, Vol. 67, No. 2, 2003, pp. 195-199. http://dx.doi.org/10.1016/S0165-5876(02)00368-3
[34]	Y. Ookouchi, N. Honda and K. Gyo, “Salivary Gland Choristoma of the Middle Ear in a Child: A Case Report,” Otolaryngology—Head and Neck Surgery, Vol. 128, No. 1, 2003, pp. 160-162. http://dx.doi.org/10.1067/mhn.2003.78
[35]	J. P. Vasama, H. Ramsay and A. Markkola, “Choristoma of the Middle Ear,” Otology & Neurotology, Vol. 22, No. 3, 2001, pp. 363-368. http://dx.doi.org/10.1097/00129492-200105000-00033
[36]	S. L. Ha, J. E. Shin and T. H. Yoon, “Salivary Gland Choristoma of the Middle Ear: A Case Report,” American Journal of Otolaryngology, Vol. 21, No. 2, 2000, pp. 127-130. http://dx.doi.org/10.1016/S0196-0709(00)85011-5
[37]	P. Supiyaphun, K. Snidvongs and S. Shuangshoti, “Salivary Gland Choristoma of the Middle Ear: Case Treated with KTP Laser,” Journal of Laryngology & Otology, Vol. 114, No. 7, 2000, pp. 528-532. http://dx.doi.org/10.1258/0022215001906066
[38]	R. A. Willis, “Some Unusual Developmental Heterotopias,” British Medical Journal, Vol. 3, 1968, pp. 267-272. http://dx.doi.org/10.1136/bmj.3.5613.267
[39]	W. F. Abadir and W. S. Pease, “Salivary Gland Choristoma of the Middle Ear,” Journal of Laryngology & Otology, Vol. 92, No. 3, 1978, pp. 247-252. http://dx.doi.org/10.1017/S0022215100085297
[40]	M. N. Nassar and O. I. Mansour, “Salivary Gland Choristoma of the Middle Ear. A Case Report and Review of the Literature,” Mediterranean Journal of Otology, Vol. 3, No. 1, 2007, pp. 47-52.
[41]	L. M. Buckmiller, H. A. Brodie, K. J. Doyle and W. Nemzek, “Choristoma of the Middle Ear: A Component of a New Syndrome?” Otology & Neurotology, Vol. 22, No. 3, 2001, pp. 363-368. http://dx.doi.org/10.1097/00129492-200105000-00015
[42]	V. Bonkowsky, B. Kochanowsky, J. Strutz, P. Pere, W. Hosemann and W. Arnold, “Delayed Facial Palsy Following Uneventful Middle Ear Surgery: A Herpes Simplex Virus Type 1 Reactivation?,” Annals of Otology, Rhinology, and Laryngology, Vol. 107, No. 11, 1998, pp. 901-905.
[43]	K. Kawaguchi, H. Inamura, Y. Abe, H. Koshu, E. Takashita, Y. Muraki, et al., “Reactivation of Herpes Simplex Virus Type 1 and Varicella-Zoster Virus and Therapeutic Effects of Combination Therapy with Prednisolone and Valacyclovir in Patients with Bell’s Palsy,” Laryngoscope, Vol. 117, No. 1, 2007, pp. 147-156. http://dx.doi.org/10.1097/01.mlg.0000248737.65607.9e