Abstract

Objective: Osteoma Occurs Almost Exclusively in The Head and Neck Region, only Rarely Present into the Facial Canal. We Reported an Incidental Finding of Osteoma in Facial Nerve Canal. Material Methods: A 35 yrs. female patient present with left ear foul smelling discharge and hearing loss since last 10yrs. On microscopic examination there was mass in post superior quadrant of tympanic membrane. On high magnification there was eroded facial canal with cholesteoma. On detail history patient give history of facial weakness which gets recovered within in 2 month on medication. High resolution computed tomography of temporal bone done to rule out exact pathology in middle ear and mastoid. Result: On otoendoscopic examination there was mass in postero superior quadrant of tympanic membrane and eroded posterior canal wall with choesteatoma. Two pathology were there one is the osteoma at facial nerve canal in vertical segment of facial nerve approximately 0.7cmx 0.8cm and cholesteoma in attic, aditus, antruma and eroding facial canal extending to mastoid tip and sinodural angle, eroding sinus plate. We removed both the pathology that is osteoma and cholesteoma and send to histopathology for confirmation. Conclusion: Osteomas are diagnosed incidentally in asymptomatic patients. Our case was symptomatic and raised the question of surgical management. This case report discusses the presentation and management of exceptional osteoma occurrence site along with presentation of cholesteoma with history of facial nerve palsy operated by mastoid exploration.