Document Detail


Hypertrophic cranial pachymeningitis associated with middle ear inflammation.
MedLine Citation:
PMID:  17006342     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe a series of patients with hypertrophic cranial pachymeningitis (HCP) associated with chronic middle ear inflammation. STUDY DESIGN: Retrospective case review. SETTING: University Hospital. PATIENTS: Six consecutive patients between the years 2000 and 2004 who had both middle ear disease and HCP (three men and three women; age range, 36-72 yr, mean age, 58.2 yr). The diagnosis of HCP was made by the use of contrast-enhanced magnetic resonance imaging scans of the brain in all patients. INTERVENTIONS: Contrast-enhanced magnetic resonance imaging (MRI) of the brain, dural biopsy, and otomicroscopic examination. MAIN OUTCOME MEASURE: Thickening and abnormal enhancement of the dura mater on the MRI of the brain. RESULTS: All of the six patients had chronic inflammatory middle ear diseases. Three patients had otitis media with effusion, two had chronic otitis media, and one had postoperative otorrhea. The most common presentations of HCP were headache and cranial nerve palsies. Cranial Nerves V and VIII were the most frequently involved. On contrast-enhanced MRI examination of the brain, an enhancement of the dura mater was observed on the same side as the middle ear diseases in five of the six patients, whereas bilateral enhancement was observed in one patient. Corticosteroid therapy was effective for alleviating the symptoms in all six patients. CONCLUSION: Chronic middle ear inflammation might be involved in the pathogenesis of HCP, probably mediated by the venous return.
Authors:
Shinichi Iwasaki; Ken Ito; Masashi Sugasawa
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  27     ISSN:  1531-7129     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-28     Completed Date:  2008-03-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  928-33     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Tokyo, Japan. iwashin-tky@umin.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chronic Disease
Cranial Nerves / pathology*
Female
Humans
Magnetic Resonance Imaging
Male
Meningitis / etiology*
Middle Aged
Otitis Media / complications*,  physiopathology
Physical Examination
Retrospective Studies
Tomography, X-Ray Computed

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