Recurrent Hydatid Disease of Temporal Bone and Skull Base: A Case Report and Literature Review.

Abstract

Hydatid disease is a parasitic infestation caused by Echinococcus granulosus. The disease is rare in the head and neck region with varying presentations. We present a rare case of recurrent hydatid disease of the temporal bone with intracranial involvement; and the treatment thereof. Hydatid disease is endemic in few parts of the world, its occurrence in head and neck region is very rare. The commonest causative organism is E. granulosus giving rise to cystic hydatid disease. Most of the former are asymptomatic, but can give rise to symptoms because of their mass effects or rupture. Our case is a 38 year male presenting to ENT department with recurrent left ear discharge, giddiness, headache and facial palsy having operated elsewhere twice in the past. The patient was investigated by Computed Tomography (CT) scanning and Magnetic Resonance Imaging (MRI) of temporal bones, head and neck regions. Which showed soft tissue attenuation of middle ear cleft and multiple cystic lesions in the middle and posterior cranial fossae indicating intracranial extension of disease. We operated for left subtotal petrosectomy with vestibular labyrinthectomy. During the perioperative period he was treated with Albendazole. Patient remains clinically and radiologically asymptomatic (post surgery 1 year) till date of this manuscript submission. Hence, we report the recurrent hydatid cyst in the temporal bone and skull base, which was managed by combination of surgical and medical treatment.