Otolaryngology: Open Access
Open Access

Abstract

Pagetâ??s disease is a chronic metabolic condition characterized by a local imbalance between the resorbing activity of osteoclasts and the osteogenic activity of osteoblasts which leads to the remodeling of bone tissue with richly vascularized foci of loose and compact bone. The cause is believed to be either viral or genetic in origin. We present a rare case of a 40-yearold female diagnosed with Pagetâ??s disease of the temporal bone and sphenoid sinus, after having been treated for 5 years for chronic otitis media. The patient presented with a mass anterior to the right ear and severe headache. She had no history of tinnitus or vertigo but complained about hearing loss. Rinneâ??s test was negative and Weberâ??s test showed lateralization to the right side. Otoneurological examination revealed a mild, mixed-type hearing loss to the right side. Cranial nerves including facial nerve were normal. There were no motor/sensory deficits or signs of cerebellar dysfunction. Radiological examination (HRCT & MRI) of the cerebral and visceral skull showed a significant osteosclerotic malformation of the right sphenoid and temporal bone with some evidence of soft tissue in the sphenoid sinus. Biopsies were taken endoscopically and histological examination led to the diagnosis of Pagetâ??s disease. It is possible that the chronic inner ear inflammation might have played a role in the development of temporal bone Pagetâ??s disease in this patient. Although temporal bone Pagetâ??s disease is very rare it can appear early with symptoms of otitis media and ENTs should include it in the differential diagnosis of patients unresponsive to treatment.

Biography

Petros Vrettakos is a resident of Otorhinolaryngology at the General Hospital of Nikaia-Piraeus â??Agios Panteleimonâ?ť (Athens, Greece). He is a PhD candidate and conducts a clinical and anatomical research on the innervation of trapezius muscle and levator scapulae muscle by the cervical nerve plexus. He has presented several researches in both Greek and international conferences.