Osteomas of the internal auditory canal: a report of two cases

To determine the optimal medical or surgical treatment of osteomas of the internal auditory canal (IAC) as well as their growth characteristics.

Information was obtained from case histories, images from computed tomography and magnetic resonance imaging, surgical and pathologic findings, and long-term clinical results.

Two patients, along with 10 additional patients reported in the literature, with osteomas of the IAC with varying symptoms were studied. Clinical history, audiometric and vestibular test results, and radiographic studies were reviewed on all patients. Histopathologic examination of the surgical specimens confirmed the presence of osteomas. The clinical outcomes were studied to determine if the preoperative symptoms had resolved.

Eight of 12 patients underwent surgical removal of their IAC osteomas. Three of eight patients had total resolution of all symptoms. Three patients had improvement of their sensorineural hearing loss. Five patients had resolution of their dizziness. Four patients noted resolution of their tinnitus. In the absence of auditory symptoms, vestibular symptoms may be controlled with medical therapy. Long term follow-up of the two patients discussed showed little or no growth over a 4- to 5-year period.

Surgical intervention may be warranted to remove an osteoma of the IAC if symptoms are present. Patients should be made aware that symptoms may or may not improve. Continuation of symptoms may be a result of chronic compression of the auditory and vestibular nerves.