The American coetaneous Leishmaniasis LTA and anthropozoonosis, endemic and growing in Brazil, affecting the skin and mucous membranes aero-digestive tract. In approximately 90% mucosal lesions of ACL, the nose is the only site affected. The involvement of the tubal ostia leads to changes in the middle ear. In this paper we report a case of a 72 year old, male patient, with TA with impaired nasal mucosa and pharynx. The infiltrative lesion of the mucosa of the Eustachian tube and the TA muscles responsible for its active opening, prevent its operation with consequent impairment of the middle ear. During a systematic investigation of these patients underwent hearing tests before and after treatment with tonal and vocal audiometry and tympanometry, which showed bilateral moderate mixed hearing loss and curve "B" in the left ear. The patient underwent treatment with meglumine antimoniate 5mg/kg in series, with improvement of mucosal lesions and closing the air-bone GAP. Through systematic Otolaryngological evaluation of these patients were able to identify middle ear resulting from impairment of the nasal mucosa. The improvement of the middle ear was obtained with the specific treatment for LTA without any other intervention, demonstrating the role of LTA in the middle ear involvement in this patient.