Osteomas of the Internal Auditory Canal: A Systematic Review and Case Report.

Osteomas of the internal auditory canal (IAC) are rare pathologies and diagnosis requires thin-slice computed tomography imaging of the skull or magnetic resonance imaging. We report a case of bilateral florid osteomas in the IAC resulting in tinnitus and vertigo. A literature review identified 29 publications, the majority case reports, meeting our criteria involving 40 patients. We examined symptomatology, laterality, diagnostic imaging, and management strategies. Regarding diagnosis, our findings affirm the importance of thorough clinical and radiological investigations. Of utmost importance, is the assessment of patient symptoms on an individual basis to determine treatment goals, as both conservative and surgical management options have risks and benefits. While conservative treatment remains appropriate for the majority of patients, those with more severe symptoms do experience benefit from a surgical strategy. Careful case selection and management of patient expectations continue to feature as a mainstay of successful treatment. This report aims to contribute to the growing body of literature on osteomas of the IAC and ultimately guide the establishment of evidence-based nationally recognized guidelines to improve care and outcomes in patients with this rare condition.