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Inicio Acta Otorrinolaringológica Española Audiovestibular Symptoms in Patients With Idiopathic Hypertrophic Pachymeningiti...
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Vol. 72. Issue 6.
Pages 387-393 (November - December 2021)
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Vol. 72. Issue 6.
Pages 387-393 (November - December 2021)
Review article
Audiovestibular Symptoms in Patients With Idiopathic Hypertrophic Pachymeningitis: Systematic Literature Review
Manifestaciones audiovestibulares en pacientes con paquimeningitis hipertrófica idiopática: Revisión sistemática de la literatura
Eugenia López-Simón
Corresponding author
eugenialopez@usal.es

Corresponding author.
, Patricia Corriols-Noval, Nathalia Castillo-Ledesma, Minerva Rodríguez-Martín, Carmelo Morales-Angulo
Unidad de Otoneurología, Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), Spain
Article information
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Tables (2)
Table 1. Review of clinical cases of idiopathic hypertrophic pachymeningitis.
Table 2. Known causes and associations with hypertrophic pachymeningitis.
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Abstract
Background and objective

Hypertrophic pachymeningitis is an infrequent inflammatory disease resulting in thickening and fibrosis of the dura mater. In most cases, the cause in unknown and is called idiopathic hypertrophic pachymeningitis (IHP). Audiovestibular symptoms are infrequent and the pathogenesis is still unclear.

Materials and methods

A systematic literature review of cases with IHP and vestibular symptoms from 2000 to February 2020 was performed. PRISMA Checklist was followed and PubMED database, Web of Science and Cochrane library were searched. We report a case of an adolescent with a diagnosis of vestibular neuritis in the context of IHP attended in our clinic.

Results

We reviewed 5 articles related to IHP and vestibular disorders. A total of 7 cases (5 women and 2 men), with ages between 27 and 68 years with IHP were found. They all had audiovestibular symptoms. In contrast to our patient, uni or bilateral neurosensorial hearing loss was reported in all cases. Furthermore, there is no other case report published describing the association between IHP and vestibular neuritis. High dose steroids improved symptoms in 85.7% of the patients.

Conclusion

Vestibular symptoms in IHP are uncommon and the pathogenesis is still debatable. Entrapment of nerves in the internal auditory canal and secondary neuronal damage could be suspected as the main cause of hearing and vestibular loss.

Keywords:
Hypertrophic pachymeningitis
Vestibular neuritis
Dizziness
Hearing loss
Resumen
Antecedentes y objetivo

La paquimeningitis hipertrófica es un proceso inflamatorio fibrosante infrecuente de la duramadre intracraneal. En la mayor parte de los casos la causa es desconocida y se denomina paquimeningitis hipertrófica idiopática (PHI). La sintomatología audiovestibular asociada es poco frecuente y su patogenia no está aclarada.

Materiales y métodos

Se realizó una revisión sistemática de literatura médica de los casos publicados de PHI asociados a sintomatología audiovestibular desde el año 2000 a febrero 2020. Se siguieron los criterios PRISMA para revisiones sistemáticas evaluando las bases de datos electrónicas PubMED, Web of Science y Cochrane. Se complementa con el caso clínico de una adolescente que debutó con neuritis vestibular en el contexto de PHI atendida en nuestro servicio.

Resultados

Se han revisado 5 artículos con casos publicados de PHI que asociaban sintomatología audiovestibular. Se encontraron un total de 7 casos (5 mujeres y 2 varones), con edades comprendidas entre los 27 y 68 años, con diagnóstico de PHI. El 100% presentaron sintomatología audiovestibular. A diferencia de nuestra paciente, todos presentaron hipoacusia neurosensorial uni o bilateral. No se ha encontrado ningún otro caso descrito de asociación entre PHI y neuritis vestibular. El tratamiento empleado fueron los corticoides consiguiendo mejoría en el 87,5% de los pacientes.

Conclusiones

Las manifestaciones vestibulares en el contexto de una PHI son muy poco fre-cuentes. La patogénesis no está clara. La principal causa de la hipoacusia y la sintomatologíavestibular podría ser el atrapamiento de los nervios en el conducto auditivo interno con dañoneuronal secundario.

Palabras clave:
Paquimeningitis hipertrófica
Neuritis vestibular
Vértigo
Hipoacusia

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