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Frequency of meningioma involvement of the middle ear is quite rare and meningioma in the middle ear can be seen either as a primary tumor or an extension of intracranial tumors. Recently, we incidentally found a meningioma in the middle ear in a 43-year-old female accompanying right tinnitus, earfullness, and hearing disturbance without any neurological symptoms. She had received ventilation tube insertion once, and came to our hospital for re-insertion of ventilation tube and further evaluation. We found a granulation tissue in the middle ear cavity during the operation of myringotomy and insertion of ventilation tube under local anesthesia, and finally confirmed by histopathologic diagnosis to have meningioma. In this report, we describe a case of middle ear meningioma originating from intracranial cavity with a review of the literatures. (J Clinical Otolaryngol 2016;27:336-339)