title: Hernia of the tympanic membrane.
abstract: Although tympanic bulging is commonly encountered, tympanic herniation occupying the external auditory canal is extremely rare. A 66-year-old man was presented to our hospital with left aural fullness, bilateral hearing loss and otorrhea. Preoperative findings suggested tympanic membrane (TM) hernia located in the left external auditory canal. We performed total resection of the soft mass by a transcanal approach using endoscopy. Ventilation tubes were inserted into bilateral ears. Histopathological findings confirmed diagnosis of TM hernia. Passive opening pressure of this patient was higher than normal condition of the Eustachian tube, where active opening was not observed. Hernia of the TM most likely resulted from long-term excessive Valsalva maneuver.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Tohoku University School of Medicine, Sendai, Japan; Sen-En Rifu Otological Surgery Center, Sendai, Japan. Electronic address: ryoukich@hotmail.com.
authors.forename: Ryoukichi
authors.initials: R
authors.lastname: Ikeda
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Tohoku University School of Medicine, Sendai, Japan; Sen-En Rifu Otological Surgery Center, Sendai, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Miyazaki
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Tetsuaki
authors.initials: T
authors.lastname: Kawase
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Katori
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Tohoku University School of Medicine, Sendai, Japan; Sen-En Rifu Otological Surgery Center, Sendai, Japan.
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Kobayashi
mesh_terms: D000368:Aged; D004424:Ear Canal; D004427:Ear Diseases / Q000601:surgery*; D004724:Endoscopy; D005064:Eustachian Tube; D006547:Hernia; D059685:Herniorrhaphy; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation; D014432:Tympanic Membrane / Q000601:surgery*; D014636:Valsalva Maneuver
keywords: Eustachian tube dysfunction; Transcanal endoscopic ear surgery; Tympanic hernia; Tympanic membrane