Refractory otitis media with effusion due to eustachian tube sialolipoma inform consistent with eustachian tube inflammatory polyp: rare case presentation and literature review

Abstract

Background: Unilateral otitis media with effusion in adult patient is considered alarming finding needing a detailed examination of the nasopharynx. The lesions in this area ranged from benign to more destructive malignant pathologies. Lipoma as a cause of obstruction is an extremely rare entity. We are reporting a case of eustachian tube lipoma presented with refractory otitis media with effusion. This is an extremely rare location of such entity and to the best of our knowledge, this is the third case reported in the world literature of eustachian tube lipoma after 2 cases published in 2011 and 2016 respectively. However, this is the first case reported in the literature of eustachian tube sialolipoma. Case presentation: We are reporting a 27-year-old male who presented to our outpatient department with a complain of unilateral ear block, hearing loss, and intermittent tinnitus. Clinical evaluation revealed unilateral otitis media with effusion that was confirmed by pure tone audiogram and tympanometry. Computed tomography and magnetic resonance imaging were obtained showed a lesion originating in the eustachian tube area protruding in the nasopharynx. Surgical removal was successful with complete recovery. Conclusions: Unilateral otitis media with effusion necessitate nasal endoscopic examination to rule-out lesions at the nasopharynx. This is the first case of sialolipoma in eustachian tube in the literature. Endoscopic removal is usually successful with uneventful short recovery period.