The evaluation of middle ear meningiomas using computerized axial tomography

Area of Science:

• Neurosurgery
• Otolaryngology
• Radiology

Background:

• Meningiomas are tumors that arise from the meninges, the membranes that surround the brain and spinal cord.
• Middle ear and mastoid meningiomas without intracranial extension are exceptionally rare.
• Previous surgical management of such cases focused on the localized tumor without routine intracranial evaluation.

Observation:

• Three patients initially diagnosed with isolated middle ear meningiomas underwent successful surgical treatment.
• These patients were presumed cured after 2-6 years of follow-up.
• Subsequent examination using computerized axial tomography (CAT) revealed unexpected, extensive intracranial meningioma components in all three.

Findings:

• A literature review identified only 13 primary meningiomas of the middle ear and mastoid.
• Definitive assessment for intracranial extension was documented in only 2 of these 13 reported cases.
• The study highlights a significant rate of occult intracranial involvement in middle ear meningiomas.

Implications:

• Patients presenting with middle ear meningiomas require thorough radiological investigation.
• Computerized axial tomography (CAT) of the head is crucial for detecting silent intracranial extensions.
• This recommendation aims to improve diagnostic accuracy and guide appropriate treatment strategies for these rare tumors.