Fibroinflammatory pseudotumor of the temporal bone

Chronic inflammatory tumor-like lesions of the temporal bone represent a di fficult clinical task for the skull base surgeon. Their osteolytic aggressi veness endangers vital structures and may not be controlled by surgery alon e. We present the course of four cases of fibroinflammatory pseudotumor of the temporal bone which were treated by a combined approach of skull base s urgery and chemotherapy. Three patients were deafened by the disease and un derwent several operative measures. One patient was lost, most likely due t o an arrosive bleeding of the internal:carotid artery. The chronic and recu rrent process could only be stopped by petrosectomy, followed by antiprolif erative chemotherapy. Two patients were subsequently provided with a cochle ar implant. The differential diagnosis, diagnostic, and operative options o f this rare but severe disease are discussed.