2016 Volume 26 Issue 1 Pages 125-131
A 70-year-old woman had been suffering from left otorrhea since 2012. She was due to undergo surgery because her otitis media was refractory. In September 2014, she was referred to our hospital for double vision due to left abducent paralysis since several days earlier. MRI revealed hypertrophic pachymeningitis extending from the left cerebellum to the left temporal lobe, and high-resolution CT of the temporal bone revealed diffuse nonerosive debris throughout the middle ear cleft. The ossicular chain was entirely intact. As we suspected that the hypertrophic pachymeningitis was caused by refractory otitis media, we examined the histopathology of the middle ear by mastoidectomy. The pathologic diagnosis was nonspecific granuloma. She was treated with steroids as we suspected that the hypertrophic pachymeningitis was related to ANCA associated vasculitis. The abducent paralysis improved in three months.
