Otoscopic examination did not reveal ear drum or middle ear alteration in any of the sides. CASE PRESENTATIONĭ.C.S., 23 year old male student, born in Belo Horizonte, came to us complaining of progressive left side hearing loss associated with a mild tinnitus in the previous 3 months, with no family history of hearing loss. The goal of this paper is to report a case of middle ear osteoma associated with conductive hearing loss, for which the diagnosis hypothesis was of otosclerosis. It is possible that they originate from the bone capsule connective tissue and they are histologically similar to those observed in the external acoustic canal. Temporal bone osteomas occur mostly in young patients, present as single-unilateral lesion, of unknown etiology. Hearing loss is conductive, unilateral and progressive. Silver et al.5 are among the authors that stressed the lack of symptoms in middle ear osteomas and, on the other hand, Muraoka et al.6 showed how important CT scan is in otorhinolaryngology in general, most specially the 3D type. Unal et al.4 also spoke about the conduction hearing loss in cases of middle ear osteomas. According to Harley et al.3 only 12 of these osteomas were found in the middle ear and they also reported that only five of these patients complained of hearing loss, while the others were diagnosed by chance. In the medical literature, there are 60 cases of temporal bone osteomas described, originating outside the external acoustic meatus2. In the temporal bone, its presence has been described in the mastoid, in the squama and in the internal auditory canal, however with marked preference for the external auditory canal1. Temporal bone osteomas have a preference for the outermost portion of the external auditory canal, while exostoses affect its most internal portion. In the temporal bone, they are usually found in the external auditory canal and are extremely rare in the middle ear. Osteomas are rare benign bone tumors of the bone lamellar portion, that usually originate from the paranasal sinuses where they are pedicled.
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