A patient with persistent right external ear discharge.
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An abnormal bony connection is seen from the right temporomandibular joint to the external ear canal.
2 case question available
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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- 2. Ajduk J, Ries M, Vagic D, Batos-Tripalo A. Temporomandibular joint fistula into the external ear canal. J Laryngol Otol. 2012 Aug;126(8):837-9.
- 3. Prowse SJ, Kelly G, Agada F. Temporomandibular joint herniation and the foramen of Huschke: an unusual external auditory canal mass. J Laryngol Otol. 2011 Dec;125(12):1279-81.