title: Lateral skull base Inflammatory pseudotumor: A systematic review.
abstract: OBJECTIVE
  Inflammatory pseudotumor (IPT) of the lateral skull base is a rare nonneoplastic inflammatory process of unknown cause often mistaken for malignancy or infection. This systematic review aims to analyze all reported cases of lateral skull base IPT to date in order to provide insight into the management of this uncommon lesion.
  
  
  METHODS
  MEDLINE/PubMed database.
  
  
  METHODS
  The MEDLINE/PubMed databases were searched for articles related to lateral skull base IPT. A bibliography review of the search results was then performed for additional articles. Demographics, presentation, radiographic findings, treatment, follow-up, and outcome were analyzed.
  
  
  RESULTS
  Thirty articles describing 39 patients were reviewed. The most common presenting symptom was hearing loss (53.8%). The mastoid bone had the highest incidence of IPT (61.5%). Computed tomography (CT) was the most utilized imaging modality. The lesion appeared isointense on T1-weighted magnetic resonance imaging (MRI) (75.0%) and hypointense on T2-weighted MRI (62.5%). Histopathological analysis showed fibrosis (96.9%) with inflammatory cell infiltration (100.0%). Surgical resection (alone or in combination with other treatments) was the most common treatment modality (92.3%), producing the greatest number of disease-free patients overall (96.0%). The mean follow-up time was 21.6 months, at which point 34.4% of patients showed improvement and 31.3% were completely disease-free.
  
  
  CONCLUSIONS
  This review is the most comprehensive analysis of lateral skull base IPT to date. A thorough workup including clinical exam, imaging, and biopsy is essential for diagnosis. Surgical excision is the most common and most successful treatment modality, followed by surgery with corticosteroids.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Eleonora F
authors.initials: EF
authors.lastname: Spinazzi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Stuti V
authors.initials: SV
authors.lastname: Desai
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Christina H
authors.initials: CH
authors.lastname: Fang
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.|Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Jyung
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.|Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.|Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: James K
authors.initials: JK
authors.lastname: Liu
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.|Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Soly
authors.initials: S
authors.lastname: Baredes
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.|Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.|Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
mesh_terms: D001847:Bone Diseases / Q000175:diagnosis* / Q000601:surgery*; D004433:Earache / Q000209:etiology; D006104:Granuloma, Plasma Cell / Q000175:diagnosis* / Q000601:surgery*; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D019291:Skull Base / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Inflammatory pseudotumor; fibroinflammatory pseudotumor; head and neck inflammatory pseudotumors; inflammatory myofibroblastic tumor; lateral skull base; otologic surgery; plasma cell granuloma; skull base approach; skull base surgery; temporal bone