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Clinicoradiologic Characteristics of Temporal Bone Meningioma: Multicenter Retrospective Analysis
Jae Joon Han1, Doh Young Lee2, Soo-Keun Kong3
1Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, South Korea.
Objectives/Hypothesis:
Meningioma is a neoplasm arising from cells related to the arachnoid villi. The aim of the present study was to explore the clinical and radiological characteristics of temporal bone meningioma (TBM) in a multicenter cohort.
Study Design:
Retrospective cohort study.
Methods:
Thirteen patients diagnosed with TBM at eight medical institutes between 1998 and 2018 were retrospectively enrolled. The clinical procedures, symptoms, signs, and images that led to the diagnosis of TBM were investigated for all patients.
Results:
The most common symptom at the initial visit was hearing loss (n = 12/13, 92.3%). All patients exhibited unilateral TBMs with varied symptom durations (1-60 months). Four patients presented masses occupying the external auditory canal; the tympanic membrane (TM) could not be evaluated. The other nine patients did not show TM perforation despite the presence of inflammatory signs. The majority of patients exhibited unilateral conductive or mixed hearing loss. A retrospective review of temporal bone computed tomography (TBCT) images revealed findings suggestive of a tumor in all patients. However, three patients had been misdiagnosed with chronic otitis media and were subjected to tympanomastoidectomy (n = 3/7, 42.9%). TBCT findings that suggested TBM included diffuse trabecular hyperostosis in the middle and posterior cranial fossae and widening and destruction of the temporal bone in the jugular bulb area.
Conclusions:
TBM should be suspected if patients exhibit persistent inflammatory symptoms or signs involving intact TM or unilateral conductive or mixed hearing loss with trabecular hyperostosis or destruction of the temporal bone on computed tomography images.
Level Of Evidence:
4 Laryngoscope, 131:173-178, 2021.
Insights
Temporal bone meningioma (TBM) often presents with hearing loss and can be misdiagnosed. Suspicion should arise with specific CT findings, prompting further investigation to avoid incorrect treatments.
Area of Science:
- Neurosurgery
- Otolaryngology
- Radiology
Background:
- Meningiomas are neoplasms originating from arachnoid villi cells.
- Temporal bone meningiomas (TBMs) are rare and can present with varied clinical and radiological features.
Purpose of the Study:
- To explore the clinical and radiological characteristics of temporal bone meningioma (TBM).
- To identify key diagnostic indicators for TBM in a multicenter cohort.
Main Methods:
- Retrospective cohort study involving thirteen patients diagnosed with TBM across eight medical institutes (1998-2018).
- Investigation of clinical procedures, symptoms, signs, and imaging findings leading to TBM diagnosis.
Main Results:
- Hearing loss was the most common initial symptom (92.3%).
- All patients had unilateral TBMs; CT scans revealed suggestive findings, though 42.9% were initially misdiagnosed.
- Key CT findings included hyperostosis and temporal bone destruction in the jugular bulb area.
Conclusions:
- TBM should be suspected in cases of persistent inflammatory symptoms with an intact tympanic membrane or unilateral hearing loss.
- Characteristic CT findings like trabecular hyperostosis and temporal bone destruction warrant consideration for TBM.
