Skull base meningiomas mimicking otitis media.

Area of Science:

• Neurology
• Otolaryngology
• Oncology

Background:

• Meningiomas are typically benign, slow-growing tumors arising from meningeal cells.
• While most meningiomas are intracranial, a small fraction occur extracranially, particularly in the ear and temporal bone.
• Extension of intracranial meningiomas into the middle ear is rare, with limited documented cases.

Observation:

• This study describes three patients where chronic otitis media was the primary presenting sign of a skull base meningioma.
• Symptoms included hearing loss, tinnitus, vertigo, and facial palsy, mimicking middle ear infections.
• Eustachian tube dysfunction leading to otitis media with effusion was also noted.

Findings:

• Diagnosis relies on advanced imaging techniques, including computed tomography (CT) and magnetic resonance imaging (MRI).
• Histopathological examination, immunophenotyping, and ultrastructural analysis confirm the diagnosis.
• In asymptomatic patients, a 'wait and scan' approach is often recommended.

Implications:

• Highlights the importance of considering rare diagnoses like meningioma in patients with persistent or unusual ear symptoms.
• Emphasizes the role of multidisciplinary collaboration between neurologists, otolaryngologists, and radiologists.
• Suggests that prompt and accurate diagnosis can lead to better patient outcomes, even with rare conditions.