Schneiderian-type papilloma of the middle ear is a rare finding. We present a 46-year-old Aboriginal man with a large tympanic membrane perforation and a Schneiderian-type papilloma filling the middle ear. The aim of this study is to familiarize clinicians with this uncommon disease through discussion of its clinical presentation, diagnostic considerations and management. A search of English-language peer-reviewed literature was undertaken using the key words ''Schneiderian-type papilloma,'' ''inverted papilloma,'' and ''middle ear.'' A total of 29 cases (including the present case) of Schneiderian-type papilloma involving the middle ear were reviewed. Common presenting symptoms include hearing loss, otalgia, and otorrhea. Middle ear disease is associated with higher rates of recurrence and malignant transformation than its sinonasal counterpart. Radical surgical resection is the only curative treatment. Schneiderian-type papilloma is a benign, but locally aggressive, epithelial neoplasm most commonly arising in the sinonasal tract. Whilst involvement of the middle ear is extremely rare, knowledge of this condition is important due to its propensity to recur and the high rate of malignant transformation.

Summary:Facial nerve paralysis because of penetrating trauma through the external auditory canal is extremely rare, with a paucity of published literature. The objective of this study is to review the literature on transtympanic facial nerve paralysis and increase physician awareness of this uncommon injury through discussion of its clinical presentation, management and prognosis. We also aim to improve patient outcomes in those that have sustained this type of injury by suggesting an optimal management plan. In this case report, we present the case of a 46-year-old white woman who sustained a unilateral facial nerve paresis because of a garfish penetrating her tympanic membrane and causing direct damage to the tympanic portion of her facial nerve. On follow-up after 12 months, her facial nerve function has largely returned to normal. Transtympanic facial nerve paralysis is a rare injury but can have a favorable prognosis if managed effectively.

Background: To review all mastoidectomies performed over a 10-year period in one tertiary hospital in Australia and evaluate the incidence and indications of operations in the Indigenous population. Methods: A retrospective review combining clinical presentations, demographics and intraoperative findings. Outcomes studied were complications on presentation, ossicular/tympanic damage present at time of operation, intra-operative pathology, the extent of the disease and the surgical technique used. Results: There were 158 mastoidectomies were performed in our institution over the 10-year period studied. Cholesteatoma (58%) was the most common indication. Extracranial complications recorded at presentation include; subperiosteal abscess, facial paralysis, labyrinthitis and significant sensory neural deafness. Intracranial complications seen include meningitis, cerebellar abscess, and encephaloceles. Canal wall down and canal wall up surgical techniques were evaluated. Conclusions: A higher number of mastoidectomies are performed on the Indigenous population, the incidence of cholesteatoma reported is lower than expected and disease recurrence rates in canal wall down and canal wall up mastoidectomies are comparable to worldwide data.

No abstract