Home Medical field Baptist Health neurosurgeon key role in study linking meningiomas to inner ear disorder with range of symptoms

Baptist Health neurosurgeon key role in study linking meningiomas to inner ear disorder with range of symptoms

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Ménière’s disease is a disorder of the inner ear that is clinically diagnosed by symptoms of fluctuating hearing loss, tinnitus, aural fullness (sensation causing muffled hearing), and vertigo. Ménière’s disease is often difficult to diagnose due to the range of symptoms typically involved.

A new study, published in the Journal of Neurosurgery, draws a critical link between this disorder and some cases of meningiomas, the most commonly diagnosed primary brain tumors in adults, the vast majority of which are non-cancerous or benign.

Michael McDermott, MD., neurosurgeon and medical director of the Miami Neuroscience Institute.

Michael McDermott, MD., neurosurgeon and chief medical director of the Miami Neuroscience Institute, part of Baptist Health, is co-author of the study, Posterior petrous meningiomas of the face with Meniere-like syndrome: a case series and review of the literature. Dr. McDermott is a world renowned leader in neuroscience, with clinical expertise in the field of meningioma surgery.

Considered the world’s foremost expert in the surgical management of meningiomas, Dr. McDermott conceptualized and designed the study, linking the classic symptoms of Ménière’s disease to meningiomas located deep within the skull.

For their review, the researchers looked at a database of 2,882 patients with intracranial meningioma who were undergoing resection or surgical removal of the tumor as well as infiltrated structures within the tumor. Of these patients, 144 had petrous tumors of the face, which are difficult to treat tumors due to their proximity to the cranial nerves, brainstem and critical vasculature. There were seven cases where patients reported Ménière-like symptoms and had posterior meningiomas of the petrous surface covering the endolymphatic sac, the nonsensory organ of the inner ear.

In each of the seven cases, the symptoms improved after the meningiomas were removed.

“Currently, most doctors don’t think these symptoms are related to this small tumour, but we show there may be a relationship,” Dr. McDermott said. “This is an important article for neurosurgeons and neurotologists who have patients with these indescribable audio vestibular symptoms that no one has been able to treat. Surgical resection works. If you remove the tumor, the symptoms go away.

Dr. McDermott pioneered optimal surgical approaches to safely and successfully resect meningiomas. His research has influenced the classification, diagnosis and grading of meningiomas. Prior to joining Baptist Health South Florida, where he is Medical Director of the Miami Neuroscience Institute, he served as Wolfe Family Endowed Professor in Meningioma Research at UCSF Medical Center in San Francisco.

While meningiomas are the most common benign brain tumor, Dr. McDermott says they rarely occur on the posterior petrous surface. He cautioned that not all patients with tumors there will experience these symptoms.

Dr. McDermott pointed out that vestibulocochlear dysfunction – such as dizziness, vertigo and balance problems – does not usually occur with posterior petrous meningiomas unless it involves the vestibular opening or the endolymphatic sac. – components of the inner ear system that controls balance. The tumor may interfere with the reabsorption of endolymphatic fluid, causing balance changes.

“The tumors are positioned in such a way that they impede the reabsorption of endolymph into the circulation. When we remove the tumor, we open up the endolymphatic sac and essentially create a shunt. This is why the patient’s symptoms disappear,” said Dr. McDermott.

Vestibular dysfunction usually improves regardless of the specific surgical approach to removing meningiomas.

“Resection of meningiomas in this specific part of the base of the skull has the potential to significantly improve the quality of life for patients struggling with these idiopathic symptoms,” Dr. McDermott said.

Tags: meningioma, Miami Neuroscience Institute, Michael McDermott MD