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Skull base meningiomas mimicking otitis media

Published online by Cambridge University Press:  12 April 2012

R Shihada*
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Bnai-Zion Medical Center, Technion–Israel Institute of Technology, Haifa, Israel
M Lurie
Affiliation:
Department of Pathology, Bnai-Zion Medical Center, Technion–Israel Institute of Technology, Haifa, Israel
M Luntz
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Bnai-Zion Medical Center, Technion–Israel Institute of Technology, Haifa, Israel
*
Address for correspondence: Dr R Shihada, Department of Otolaryngology–Head and Neck Surgery, Bnai-Zion Medical Center, Technion–Israel Institute of Technology, PO Box 4940, 31048 Haifa, Israel Fax: +972 4 8539485 E-mail: rabia.shihada@b-zion.org.il

Abstract

Introduction:

Meningiomas are slow-growing, benign tumours originating from the arachnoid villi of the meninges. They account for 13 to 26 per cent of all intracranial neoplasms. Less than 1 per cent of all meningiomas are primary extracranial tumours of the ear and temporal bone. Intracranial meningiomas extending to the middle-ear cleft are uncommon, with fewer than 100 cases reported to date. Presenting symptoms of the latter condition may include hearing loss, tinnitus, dizziness, vertigo and facial palsy. Otitis media with effusion secondary to eustachian tube dysfunction has also been reported.

Aim:

To describe three patients in whom chronic otitis media was the presenting sign of skull base meningioma.

Method:

Case presentations.

Results:

Presentation of clinical and imaging findings as well as management considerations.

Conclusion:

Meningioma involving the middle ear is an extremely rare condition, and is diagnosed by computed tomography in conjunction with magnetic resonance imaging. When biopsy is performed, the histological features, characteristic immunophenotype and ultrastructural analysis are valuable aids to definitive diagnosis. In patients with no neurological symptoms, ‘wait and scan’ is often the best management option.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

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