Posterior medial extension osteochondroma of mandibular head causing hearing loss

Osteochondroma is a benign bone tumor that often presents with malocclusion and facial asymmetry when it occurs in the mandibular condyle. We report a rare case of a female patient in her 80s with an osteochondroma of the right mandibular condyle extending posteromedially, compressing and narrowing the external auditory canal (EAC), resulting in conductive hearing loss. She underwent resection of the mandibular condyle, resulting in EAC decompression and subjective improvement in hearing. The unusual growth pattern of the tumor in this case likely contributed to the absence of typical symptoms, resulting in a delayed diagnosis. A literature review revealed that tumors that cause EAC stenosis often exhibit posteromedial growth, indicating a unique growth pattern. When evaluating hearing loss in the older population, tumorous lesions in the maxillofacial region should be considered in the differential diagnosis in addition to age-related changes.