Internal auditory canal osteoma: Wait or operate – Case report and literature review

Abstract

Internal auditory canal osteomas (IACOs) are rare, slow-growing, and benign bone tumors. They are most often found incidentally with few-reported cases. Osteomas involving the internal auditory canal (IAC) are particularly rare. The symptoms of the IACO usually arise due to direct pressure on the vestibulocochlear nerve; however, etiology, mechanism, and management remain unclear. The present report describes the rare case of IACO involving a 15-year-old male who was referred to a tertiary referral center with a history of chronic supportive otitis media, which was otherwise asymptomatic. The ensuing discussion and brief literature review address whether to wait or operate. IACO in this patient exhibited slow-growing features, and audiology assessment revealed no sensory neural hearing loss. Computed tomography (CT) revealed a round, radiopaque pedunculated bony outgrowth in the right IAC. Magnetic resonance imaging using a selected T2-weighted sequence revealed the osteoma projecting from the posterior superior aspect of the right IAC. Accordingly, clinical observation was recommended. Observation, including serial CT, is recommended for asymptomatic patients. Surgery is not advisable in slow-growing and asymptomatic cases because the risks are due to its dangerous location. Decisions regarding the management must consider according to symptom severity, progression, and risks in surgery. The question of whether to operate, therefore, should be carefully considered depending upon patient complaints and medical findings.