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Hypertrophic chronic pachymeningitis associated with chronic otitis media and mastoiditis

Sho Kanzaki1, Yasuhiro Inoue, Takahisa Watabe

  • 1Department of Otolaryngology, Head and Neck Surgery, Keio University Hospital, 35 Shinanomachi, Shinjuku, Tokyo 160-0082, Japan. skan@sc.itc.keio.ac.jp

Auris, Nasus, Larynx
|May 4, 2004
PubMed

Insights

A 70-year-old female experienced hearing loss, facial paralysis, and vertigo due to middle ear inflammation. Surgical removal of infected tissue (mastoidectomy) improved her condition and reduced inflammation.

Area of Science:

  • Neurology
  • Otolaryngology
  • Radiology

Background:

  • Middle ear inflammation can lead to serious complications, including pachymeningitis.
  • Bilateral hearing disturbance, facial paralysis, and vertigo are significant symptoms requiring investigation.

Observation:

  • A 70-year-old female presented with bilateral hearing disturbance, facial paralysis, and vertigo.
  • Radiological imaging revealed soft tissue in the mastoid and tympanic cavities, with prominent meningeal enhancement on MRI.
  • The patient's condition declined due to middle ear inflammation inducing pachymeningitis.

Findings:

  • Bilateral mastoidectomies were performed, leading to improvement in the patient's general condition.
  • Hearing improved on the right side post-ossiculoplasty; facial movement and pachymeningitis also diminished.
  • Surgical removal of infectious granulation effectively ameliorated acute inflammation.

Implications:

  • Surgical intervention for chronic middle ear inflammation can resolve associated neurological symptoms.
  • Prompt diagnosis and treatment are crucial for managing complex cases of otitis media with meningeal involvement.
  • Further research is needed to identify the unknown etiology in such cases.

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