Nodular fasciitis is a benign, pseudosarcomatous proliferative lesion of soft tissue. Only 7% to 20% of these tumors are located in the head and neck with ear involvement being extremely rare. We present a patient with nodular fasciitis arising in the external auditory canal (EAC). CASE REPORTA 39-year-old man came to our emergency department with a 2-week history of a mass protruding from the left ear. Examination revealed a fungating, ulcerative lesion protruding from the left EAC and filling the concha (Fig 1). The mass was associated with minimal pain and drainage. CT done in the emergency department revealed the mass to be confined to the left EAC without middle ear invasion (Fig 2). The patient was then scheduled for an MRI and follow-up in the otology clinic. The MRI showed a high-signal mass throughout the left EAC and middle ear cavity with extension inferiorly to involve the parotid gland, temporomandibular joint, masseter, and pterygoid muscles. There was no evidence of great vessel or lymph node involvement (Fig 3). In addition a biopsy was obtained with the patient under local anesthesia. Pathologic evaluation revealed an ulcerated, mesenchymal proliferation. Distinction between a low-grade sarcoma and a benign reactive process was extremely difficult. The patient was prepared to undergo an extensive resection of the left temporal bone. The specimen was then sent for outside pathologic consultation. This confirmed the presence of a reactive process. The lesion was comprised of flat, spindled cells with a "tissue culture-like" appearance. There was also a focus of metaplastic bone. Mitoses were present with minimal nuclear atypia (Fig 4). The lesion was diagnosed as nodular fasciitis.Subsequently, the patient was taken to the operating room where he underwent a local excision that included approximately one third of the left EAC.

This new stent demonstrated safety and biocompatibility with minimal local tissue reaction to its extended long-term placement. Good tolerance to the stent was documented, with minimal side effects similar to those that would be observed in human subjects after endotracheal intubation. When followed up in human patients, such minimal lesions have not resulted in significant long-lasting functional impairments. These initial results would indicate that this stent is well tolerated for long-term application and qualify as the preferred device for both management of aspiration and postoperative endolaryngeal bolstering support.

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