Lipoma of the middle ear: an unusual presentation in a 6 year old child.

A 6-year-old girl with Down syndrome was referred to our team for joint management. She was having severe speech and language difficulties. Her hearing was assessed, and the pure tone audiometry showed a moderate conductive hearing loss (40 dB) in the left ear and profound hearing loss in the right ear. A CT scan and MRI of temporal bone (Figs. 1 and 2) revealed a hypodense mass in the left tympanic cavity and malformation of the right inner ear. Examination revealed a yellowish opaque mass showing through the antero-inferior segment of the tympanic membrane, and the right tympanic membrane was normal. Left middle ear exploration was done, and this revealed an encapsulated lump of fatty tissue filling the anterior middle ear space; the ossicles were intact. The incus and malleus head were removed in order to obtain access to the epitympanum and ossiculoplasty was done by putting the cartilage between malleus and stapes. Histologic studies revealed fiboadipose tissue