Alzahrani Musaed, Gaboury Louis, Saliba Issam
Division of Otorhinolaryngology, Head & Neck Surgery, Montreal University Hospital Center (CHUM), 1560 Rue Sherbrooke Est, Montréal, QC, Canada H2L 4M1.
Department of Pathology and Cell Biology, University of Montreal, 6128 Succursale Centre-ville, Montréal, QC, Canada H3C 3J7.
Case Rep Med. 2013;2013:396805. doi: 10.1155/2013/396805. Epub 2013 Dec 19.
A 48-year-old woman presented with unilateral hearing loss and tinnitus for three years associated with middle ear effusion. Previous treatments, including antibiotics, corticoids, and transtympanic tube, were ineffective. Otomicroscopy showed a greyish retrotympanic mass associated with middle ear effusion. High resolution CT scan of the mastoid was in favor of chronic oto-mastoiditis without any evidence of tegmen dehiscence. Surgical exploration revealed a polypoid greyish mass filling the tympanic cavity. Histological examination postoperatively revealed a meningothelial meningioma. Postoperative magnetic resonance imaging (MRI) was obtained and showed a large skull base meningioma, extending from the clivus anteriorly to the porus acusticus posteriorly with middle ear invasion. After discussion with the multidisciplinary tumor board, it was managed by stereotactic radiotherapy due to the high surgical associated neurovascular risks. In conclusion, middle ear meningioma, although still a rare presentation, should be suspected in the presence of atypical chronic OME.
一名48岁女性，出现单侧听力损失和耳鸣三年，伴有中耳积液。先前的治疗，包括使用抗生素、皮质类固醇和鼓膜置管，均无效。耳镜检查显示鼓膜后有一个灰白色肿物，伴有中耳积液。乳突高分辨率CT扫描显示为慢性耳乳突炎，没有任何鼓室盖裂开的迹象。手术探查发现一个息肉样灰白色肿物充满鼓室。术后组织学检查显示为脑膜内皮型脑膜瘤。术后进行了磁共振成像（MRI）检查，显示一个巨大的颅底脑膜瘤，从前斜坡延伸至后内耳道，侵犯中耳。与多学科肿瘤委员会讨论后，由于手术相关的神经血管风险较高，采用立体定向放射治疗。总之，中耳脑膜瘤虽然仍然少见，但在出现非典型慢性中耳炎时应予以怀疑。
