Otolaryngologic manifestations of posterior fossa arachnoid cysts

Posterior fossa arachnoid cysts are more common than previously reported. While they may present with symptoms of hearing loss, vertigo, and tinnitus, often they are associated with vague, nonspecific complaints such as headache, dizziness, or generalized unsteadiness. We present five cases of posterior fossa arachnoid cysts discovered in adult patients. Four of the five patients had nonlocalizing symptoms (three of those sought medical evaluations for persistent dizziness and/or headache). Two patients had prolonged symptoms despite medical evaluation and normal audiometric testing before the correct diagnosis was made. We describe the case of our senior author (C.P.D.) in detail and include computerized tomographic and nuclear magnetic resonance studies outlining his pathology. A review of the management of these lesions is included. Dizzy patients and those patients with nonspecific complaints referable to the inner ear or posterior fossa who have normal audiometric testing, and in whom the index of suspicion is high, should have high resolution computerized tomography of the posterior fossa.