Abstract：
OBJECTIVE: Ménière\'s disease is an inner ear disorder classically characterized by fluctuating hearing loss, tinnitus, and aural fullness accompanied by episodic vertigo. While the pathogenesis of Ménière\'s remains under debate, histopathological analyses implicate endolymphatic sac dysfunction with inner ear fluid homeostatic dysregulation. Little is known about whether external impingement of the endolymphatic sac by tumors may present with Ménière\'s-like symptoms. The authors present a case series of 7 patients with posterior fossa meningiomas that involved the endolymphatic sac and new onset of Ménière\'s-like symptoms and review the literature on this rare clinical entity.
METHODS: A retrospective review of patients undergoing resection of a posterior petrous meningioma was performed at the authors\' institution. Inclusion criteria were age older than 18 years; patients presenting with Ménière\'s-like symptoms, including episodic vertigo, aural fullness, tinnitus, and/or hearing loss; and tumor location overlying the endolymphatic sac.
RESULTS: There were 7 cases of posterior petrous face meningiomas involving the vestibular aperture presenting with Ménière\'s-like symptoms. Imaging and intraoperative examination confirmed no cranial nerve VIII compression or labyrinthine artery involvement accounting for audiovestibular symptoms. Of the 7 patients in the series, 6 experienced significant improvement or resolution of their vertigo, and all 7 had improvement or resolution of their tinnitus after resection. Of the 5 patients who had preoperative hearing loss, 2 experienced improvement or resolution of their ipsilateral preoperative hearing deficit, whereas the other 3 had unchanged hearing loss compared to preoperative evaluation.
CONCLUSIONS: Petrous face meningiomas overlying the endolymphatic sac can present with a Ménière\'s syndrome. Early recognition and microsurgical excision of these tumors is critical for resolution of most symptoms and stabilization of hearing loss.
METHODS: A retrospective review of patients undergoing resection of a posterior petrous meningioma was performed at the authors\' institution. Inclusion criteria were age older than 18 years; patients presenting with Ménière\'s-like symptoms, including episodic vertigo, aural fullness, tinnitus, and/or hearing loss; and tumor location overlying the endolymphatic sac.
RESULTS: There were 7 cases of posterior petrous face meningiomas involving the vestibular aperture presenting with Ménière\'s-like symptoms. Imaging and intraoperative examination confirmed no cranial nerve VIII compression or labyrinthine artery involvement accounting for audiovestibular symptoms. Of the 7 patients in the series, 6 experienced significant improvement or resolution of their vertigo, and all 7 had improvement or resolution of their tinnitus after resection. Of the 5 patients who had preoperative hearing loss, 2 experienced improvement or resolution of their ipsilateral preoperative hearing deficit, whereas the other 3 had unchanged hearing loss compared to preoperative evaluation.
CONCLUSIONS: Petrous face meningiomas overlying the endolymphatic sac can present with a Ménière\'s syndrome. Early recognition and microsurgical excision of these tumors is critical for resolution of most symptoms and stabilization of hearing loss.
摘要：
目的：Ménière病是一种内耳疾病，其典型特征是波动性听力损失，耳鸣,并伴有发作性眩晕。虽然梅尼埃的发病机制仍在争论中，组织病理学分析提示内淋巴囊功能障碍伴有内耳液稳态失调。关于肿瘤对内淋巴囊的外部撞击是否会出现类似梅尼埃的症状，人们知之甚少。作者介绍了一系列7例后颅窝脑膜瘤患者，这些患者涉及内淋巴囊和新发的Ménière样症状，并回顾了有关这种罕见临床实体的文献。
方法：作者机构对接受后岩性脑膜瘤切除术的患者进行了回顾性回顾。纳入标准为年龄大于18岁；出现梅尼埃症状的患者，包括发作性眩晕,听觉丰满，耳鸣,和/或听力损失;以及覆盖内淋巴囊的肿瘤位置。
结果：有7例涉及前庭孔的后岩面脑膜瘤，表现为Ménière样症状。影像学和术中检查证实，没有颅神经VIII压迫或迷路动脉受累，从而导致听前庭症状。在该系列的7名患者中，6经历了眩晕的显着改善或解决，切除后，所有7人的耳鸣均得到改善或缓解。在术前听力损失的5例患者中,2例同侧术前听力缺陷改善或消退，而与术前评估相比，其他3例听力损失没有变化。
结论：内淋巴囊上覆的面部岩性脑膜瘤可表现为Ménière综合征。这些肿瘤的早期识别和显微外科切除对于解决大多数症状和稳定听力损失至关重要。
方法：作者机构对接受后岩性脑膜瘤切除术的患者进行了回顾性回顾。纳入标准为年龄大于18岁；出现梅尼埃症状的患者，包括发作性眩晕,听觉丰满，耳鸣,和/或听力损失;以及覆盖内淋巴囊的肿瘤位置。
结果：有7例涉及前庭孔的后岩面脑膜瘤，表现为Ménière样症状。影像学和术中检查证实，没有颅神经VIII压迫或迷路动脉受累，从而导致听前庭症状。在该系列的7名患者中，6经历了眩晕的显着改善或解决，切除后，所有7人的耳鸣均得到改善或缓解。在术前听力损失的5例患者中,2例同侧术前听力缺陷改善或消退，而与术前评估相比，其他3例听力损失没有变化。
结论：内淋巴囊上覆的面部岩性脑膜瘤可表现为Ménière综合征。这些肿瘤的早期识别和显微外科切除对于解决大多数症状和稳定听力损失至关重要。
