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Clinical Note |

Chronic Pachymeningitis and Bilateral Facial Paralysis Secondary to Renal Osteodystrophy

Vikram Shenoy, MS; John S. Oghalai, MD
Arch Otolaryngol Head Neck Surg. 2008;134(3):324-326. doi:10.1001/archoto.2007.23.
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Heterotopic calcification can occur as a result of secondary or tertiary hyperparathyroidism.1 Herein we describe a patient with end-stage renal disease who has had several episodes of facial palsy bilaterally. Clinical evaluation, medical testing, radiographic imaging, and, finally, surgery revealed facial nerve compression secondary to dural calcification. An extensive literature search demonstrated that dural calcifications resulting in facial paralysis has not been previously described to our knowledge.

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Figure.

A, T1-weighted, fat-saturated, postgadolinium-enhanced, axial magnetic resonance image shows extensive linear dural enhancement (arrows), including the right internal auditory canal. B, Extensive dural calcifications seen on computed tomographic scan (arrows). C, New bone formation at level of geniculate ganglion seen on computed tomographic scan (arrow). D, Dural biopsy specimen reveals multiple areas of heterotopic bone formation (solid arrows). The extradural and intradural sides of the tissue are labeled (hematoxylin-eosin ×40).

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