A case of schwannoma in the middle ear cavity misdiagnosed as cholesteatoma

Schwannoma is slow-growing, benign neurogenic tumor arising from schwann cells and rarely occurs in the middle ear cavity. The origins of primary schwannoma in the middle ear are the facial nerve, chorda tympanic nerve, and Jacobson’s nerve. Only a few cases have been reported of sympa-thetic plexus of the internal carotid nerve as the origin of primary schwannoma. We present a case of a 62-year-old male patient who have had recurrent otitis media for 20 years and accompanied by pus like discharge, otalgia, and hearing loss. On otologic examination, we found whitish mass in the middle ear cavity and performed temporal bone CT and MRI. There was soft tissue density filled the middle ear cavity with expansion of internal carotid canal petrous portion. We performed surgical exploration to rule out recurrence of chronic otitis media with cholesteatoma, the most common neoplasm in the middle ear cavity. The result of the biopsy was schwannoma. We report a case of schwannoma, which was suspected to be originated from sympathetic plexus of carotid artery.