Osteomas of the internal auditory canal: A report of two cases

Objectives: To determine the optimal medical or surgical treatment of osteo mas of the internal auditory canal (IAC) as well as their growth characteri stics. Study Design: Information was obtained from case histories, images from com puted tomography and magnetic resonance imaging, surgical and pathologic fi ndings, and long-term clinical results. Methods: Two patients, along with 10 additional patients reported in the li terature, with osteomas of the IAC with varying symptoms were studied. Clin ical history, audiometric and vestibular test results, and radiographic stu dies were reviewed on all patients. Histopathologic examination of the surg ical specimens confirmed the presence of osteomas. The clinical outcomes we re studied to determine if the preoperative symptoms had resolved. Results: Eight of 12 patients underwent surgical removal of their IAC osteo mas, Three of eight patients had total resolution of all symptoms. Three pa tients had improvement of their sensorineural hearing loss. Five patients h ad resolution of their dizziness. Four patients noted resolution of their t innitus. In the absence of auditory symptoms, vestibular symptoms may be co ntrolled with medical therapy. Long term follow-up of the two patients disc ussed showed little or no growth over a 4- to 5-year period. Conclusions: Surgical intervention may be warranted to remove an osteoma of the IAC if symptoms are present. Patients should be made aware that sympto ms may or may not improve. Continuation of symptoms may be a result of chro nic compression of the auditory and vestibular nerves.