An unusual posterior cranial fossa tumour causing hearing loss

Clivus meningioma is an uncommon tumour arising from the region of the synchrondrosis between the basal portions of the sphenoid and occipital bones. We report a case of a patient with a large meningioma of the clivus whose presenting symptom was auditory change. Alteration of hearing is a rare mode of presentation for such a tumour although it may present at a later stage in about 50 per cent of cases. The discrepancy between the size of the tumour and the paucity of physical findings, the value of a multiple test auditory screening strategy, and the surgical approach in this case are discussed.