title: Inverted papilloma of the sphenoid sinus presenting with auditory symptoms: a report of two cases.
abstract: OBJECTIVE
  The report aims to inform the reader of cases of inverted papilloma involving the sphenoid sinus presenting with auditory symptoms.
  
  
  METHODS
  Case series.
  
  
  METHODS
  A retrospective medical record analysis was carried out to identify patients with inverted papilloma involving the sphenoid sinus that presented with a primary complaint of hearing loss or tinnitus, or both. Clinical records, including initial history and physical examination, audiologic and radiologic studies, and operative and histopathologic reports, were carefully examined. A complete literature review for relevant studies was performed to explore possible pathophysiologic factors and similar cases.
  
  
  RESULTS
  Two patients with inverted papilloma presenting with primary auditory complaints were identified. One patient had roaring tinnitus and sensorineural hearing loss demonstrated with audiologic assessment, whereas the other had pulsatile tinnitus. Both patients had biopsy-proven inverted papilloma involving the sphenoid sinus, and both patients underwent endoscopic resection of the disease. No other cause or origin of their auditory symptoms was confirmed. The auditory symptoms of both patients improved markedly after excision of their inverted papillomas.
  
  
  CONCLUSIONS
  Tinnitus with or without hearing loss is an unusual presentation of inverted papilloma of the sphenoid sinus. Sphenoid tumors should be considered in the workup of these symptoms.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia 19104, U.S.A. eisenm@mail.med.upenn.edu
authors.forename: Marc D
authors.initials: MD
authors.lastname: Eisen
authors.forename: Luke
authors.initials: L
authors.lastname: Buchmann
authors.forename: Richard S
authors.initials: RS
authors.lastname: Litman
authors.forename: David W
authors.initials: DW
authors.lastname: Kennedy
mesh_terms: D000328:Adult; D003638:Deafness / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018308:Papilloma, Inverted / Q000150:complications*; D010255:Paranasal Sinus Neoplasms / Q000150:complications*; D012189:Retrospective Studies; D013101:Sphenoid Sinus; D014012:Tinnitus / Q000209:etiology*