Shihada R, Lurie M, Luntz M
Department of Otolaryngology-Head and Neck Surgery, Bnai-Zion Medical Center, Technion-Israel Institute of Technology, Haifa, Israel.
J Laryngol Otol. 2012 Jun;126(6):619-24. doi: 10.1017/S0022215112000539. Epub 2012 Apr 12.
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.
To describe three patients in whom chronic otitis media was the presenting sign of skull base meningioma.
Case presentations.
Presentation of clinical and imaging findings as well as management considerations.
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.
脑膜瘤是起源于脑膜蛛网膜绒毛的生长缓慢的良性肿瘤。它们占所有颅内肿瘤的13%至26%。所有脑膜瘤中不到1%是耳部和颞骨的原发性颅外肿瘤。延伸至中耳裂的颅内脑膜瘤并不常见，迄今为止报道的病例少于100例。后者的症状可能包括听力丧失、耳鸣、头晕、眩晕和面瘫。也有报道称继发于咽鼓管功能障碍的分泌性中耳炎。
描述3例以慢性中耳炎为颅底脑膜瘤首发症状的患者。
病例报告。
临床和影像学表现以及治疗考虑因素。
累及中耳的脑膜瘤极为罕见，通过计算机断层扫描结合磁共振成像进行诊断。进行活检时，组织学特征、特征性免疫表型和超微结构分析有助于明确诊断。对于没有神经症状的患者，“观察并扫描”通常是最佳治疗选择。
