Idiopathic intracranial hypertension in otolaryngology

Abstract

Idiopathic intracranial hypertension (IIH) is defined as increased intracranial pressure in the absence of intracranial mass or obstructive hydrocephalus. Over 80% of patients are overweight women. IIH is usually encountered in the neurology and ophthalmology practise as headaches, visual disturbance and papilloedema are the characteristic features of this syndrome. Patients with IIH also experience tinnitus, hearing loss, balance disturbance, cerebrospinal fluid (CSF) otorrhoea or rhinorrhoea and in some cases these otorhinological symptoms can be presenting features of this syndrome. IIH is also associated with obstructive sleep apnoea. Otolaryngologists should be familiar with this important condition as it can manifest a variety of symptoms that are more frequently seen in their clinics. Sometimes otolaryngologists may be involved in the surgical management of this condition, such as repair of CSF rhinorrhoea or otorrhoea or endoscopic optic nerve decompression. The aim of this review article is to familiarise the otolaryngologists with the important features of this unusual syndrome which may remain unrecognised in the otolaryngology practice.

Pearls & Oy-sters: A rare presentation of chronic intracranial hypertension with concurrent deafness and blindness

“…The classic reported otologic features of elevated ICP are tinnitus and aural fullness; however, both conductive hearing loss and SNHL have been reported. 4,5 Our patient presented with bilateral severe auditory neuropathies possibly due to stretch of the vestibulocochlear nerves from the increased ICP. 5 Protrusion of the meningoceles into the IACs was also deemed to be a contributing factor to the hearing loss in our case.…”

High Pseudotumor Cerebri Incidence in Tretinoin and Arsenic Treated Acute Promyelocytic Leukemia and the Role of Topiramate After Acetazolamide Failure

“…PTC secondary to ATRA administration for APL has been well described in the literature through case reports in both the pediatric and young adult populations [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] and, among adults, has been most often associated with obese women of childbearing age [34]. However, all patients described in this report were males with a wide age range and body mass indexes (BMIs) consistent with an overweight (BMI 25.0-29.9 kg/m 2 ) or obese (BMI Z30 kg/m 2 ) stature.…”

A case report of all-trans retinoic acid-induced pseudotumor cerebri in an adult patient of acute promyelocytic leukemia

“…9 Drug-induced PTC is implicated to be associated tetracyclines, growth hormone, oral contraceptives, thyroid analogs, vitamin A derivatives, lithium, and withdrawal of steroid. There is little knowledge about the exact pathogenesis of ATRA-induced PTC.…”