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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: [email protected]

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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References

1Whittle, IR, Smith, C, Navoo, P, Collie, D. Meningiomas. Lancet 2004;363:1535–43CrossRefGoogle ScholarPubMed
2Ayache, D, Trabalzini, F, Bordure, P, Gratacap, B, Darrouzet, V, Schmerber, S et al. Serous otitis media revealing temporal en plaque meningioma. Otol Neurotol 2006;27:992–8CrossRefGoogle ScholarPubMed
3Chang, CY, Cheung, SW, Jackler, RK. Meningiomas presenting in the temporal bone: the pathways of spread from an intracranial site of origin. Otolaryngol Head Neck Surg 1998;119:658–64CrossRefGoogle ScholarPubMed
4Civantos, F, Ferguson, LR, Hemmati, M, Gruber, B. Temporal meningiomas presenting as chronic otitis media. Am J Otol 1993;14:403–6Google Scholar
5Khalaila, J, Braun, J, Lurie, M, Zaaroor, M, Luntz, M. Meningioma extending into the middle ear mimicking chronic otitis media. Isr Med Assoc J 2008;10:544–5Google Scholar
6Nager, GT. Meningiomas involving the temporal bone: clinical and pathological aspects. Isr J Med Sci 1966;6:6996Google ScholarPubMed
7Rowland, LP. Tumors of the meninges. In: Rowland, LP, ed. Merritt's Textbook of Neurology, 9th edn.Baltimore: Williams & Wilkins, 1995;329–35Google Scholar
8Marosi, C, Hassler, M, Roessler, K, Reni, M, Sant, M, Mazza, E et al. Meningioma. Crit Rev Oncol Hematol 2008;67:153–71CrossRefGoogle ScholarPubMed
9Johnson, WD, Loredo, LN, Slater, JD. Surgery and radiotherapy: complementary tools in the management of benign intracranial tumors. Neurosurg Focus 2008;24:E2Google Scholar
10Yano, S, Kuratsu, J. Indications for surgery in patients with asymptomatic meningiomas based on an extensive experience. J Neurosurg 2006;105:538–43Google Scholar