title: Skull base meningiomas mimicking otitis media.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  To describe three patients in whom chronic otitis media was the presenting sign of skull base meningioma.
  
  
  METHODS
  Case presentations.
  
  
  RESULTS
  Presentation of clinical and imaging findings as well as management considerations.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Bnai-Zion Medical Center, Technion-Israel Institute of Technology, Haifa, Israel. rabia.shihada@b-zion.org.il
authors.forename: R
authors.initials: R
authors.lastname: Shihada
authors.forename: M
authors.initials: M
authors.lastname: Lurie
authors.forename: M
authors.initials: M
authors.lastname: Luntz
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000209:etiology; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008579:Meningioma / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications / Q000175:diagnosis*; D038781:Otoscopy; D019292:Skull Base Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D057832:Watchful Waiting