A 24-year-young female presented in our Clinic with a history of vertigo diagnosed and treated in neurology department as a Meniere disease with frequent recurrences since almost 3 years, progressive hearing loss in the left ear. It starts insidious but became gradually progressive. She describe also a continue dizziness, not an attack like in Meniere and also notice a progressive deafness and tinnitus more recent .From the last year she start to accuse headache ,and vomiting with release of the pain . There was no history of previous ear infection or trauma. Past medical history of the patient did not reveal any significant disease and the family history was unremarkable. There was no family history of bone diseases, skin disorders, genetic abnormalities, or endocrinopathies. She was treated in a few cases in the hospital with pev containing vasodilators and vitamins like B1,B6 ,B12 ,and steroids., In rest she take po when Arlevert-Cinnarizine when Betaserc-berahistine and My gamma N -vit B complex with no results . On physical examination, she was in a good general status, there was no mastoid tenderness, and face was symmetric. Left-sided otoscopy showed mild retraction of pars tensa. Tuning fork tests-revealed an important deafness on the left ear. Vestibular examination with Romberg test, Untenberger, Babinski, coordination test like nose-index, also was positive for a lesion of the left labyrinth. Nistagmus was positive, horizontal rotatory, the remainder of the head and neck examination was totally normal [1][2][3][4][5].
Laboratory Test -were Normal AudiometryPure Tone Audiometry: Demonstrated a moderately severe mixed hearing loss with a pure tone air conduction average of 95 dB hearing level (masked) and a 50 dB air-bone gap on his left ear.Immitance audiometry: Type B -line-, stampeding reflex absent. Figure 1: MRI-axial view -the cavities of inner, middle ear, mastoid process and temporal bone are filled by a solid mass with extension in the posterior cranial fossa.