Boston University Medical Center, Department of Otolaryngology, 800 Harrison Ave, BCD Building, 5th Floor, Boston, MA, United States of America; Division of Otolaryngology-Head and Neck Surgery, Lahey Hospital and Medical Center, Burlington, MA, United States of America.
Division of Radiology, Lahey Hospital and Medical Center, Burlington, MA, United States of America.
Am J Otolaryngol. 2024 Jul-Aug;45(4):104263. doi: 10.1016/j.amjoto.2024.104263. Epub 2024 Mar 18.
To describe a rare complication of cholesteatoma.
Case report with literature review.
We report a case of a 37-year-old male who presented for evaluation of otorrhea, headache, and progressive left sensorineural hearing loss. Clinical and radiologic evaluation demonstrated a large recurrent attic cholesteatoma with erosion into the lateral and superior semicircular canals, and diffuse enhancement of the internal auditory canal and cerebellopontine angle suggestive of hypertrophic pachymeningitis secondary to cholesteatoma. After treatment with a course of antibiotics and canal wall down mastoidectomy surgery for cholesteatoma exteriorization, he experienced improvement of his symptoms and resolution of hypertrophic pachymeningitis.
Hypertrophic pachymeningitis is a rarely described complication of cholesteatoma. In the context of cholesteatoma, treatment with antibiotics and surgical removal or exteriorization of cholesteatoma are effective treatments for HP.
描述胆脂瘤的一种罕见并发症。
病例报告并文献复习。
我们报告了 1 例 37 岁男性患者，因耳漏、头痛和进行性左侧感音神经性听力损失就诊。临床和影像学评估显示大型复发性鼓室天盖胆脂瘤，侵蚀外侧和上半规管，并弥漫性强化内听道和桥小脑角，提示胆脂瘤继发肥厚性脑膜炎。在使用抗生素治疗并进行鼓室壁下降乳突切除术以将胆脂瘤外露后，他的症状得到改善，肥厚性脑膜炎也得到缓解。
肥厚性脑膜炎是胆脂瘤少见的并发症。在胆脂瘤的情况下，抗生素治疗和手术切除或外露胆脂瘤是治疗 HP 的有效方法。
