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Foramen tympanicum

Case contributed by Yune Kwong
Diagnosis certain

Presentation

A patient with persistent right external ear discharge.

Patient Data

Age: 40 years old
Gender: Male
ct

An abnormal bony connection is seen from the right temporomandibular joint to the external ear canal.

Case Discussion

The foramen tympanicum (also known as foramen of Huschke) is a bony defect between the external acoustic canal (EAC) and the temporomandibular joint (TMJ). Most cases are asymptomatic, but it can be the cause of persistent ear discharge following mastication due to the connection with the TMJ.

HRCT of the petrous temporal bone is the study of choice. The foramen tympanicum arises in the antero-inferior part of the EAC, and is postero-medial to the TMJ.

In our patient, the symptoms resolved spontaneously and further treatment was not required. However, surgery has been described to obliterate the foramen, and also to deal with any herniation of TMJ tissue or any salivary gland fistula.

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