Malignant infantile osteopetrosis: otolaryngological complications and management

Arch Otolaryngol Head Neck Surg. 1998 Jun;124(6):689-94. doi: 10.1001/archotol.124.6.689.

Abstract

Objectives: To inform otolaryngologists about upper airway obstruction requiring tracheotomy and other otolaryngological manifestations of malignant infantile osteopetrosis (MIOP) and to discuss pathophysiological features, management, and new treatment strategies in MIOP.

Design: Ongoing case series combined with a retrospective chart review.

Setting: International tertiary pediatric hospital.

Interventions: Patients with MIOP were initially referred for treatment and routine follow-up. Tracheotomy was performed to manage obstructive sleep apnea. Audiograms were also performed at regular intervals.

Results: The records of 9 patients were examined. The otolaryngological findings of hearing loss, obstructive sleep apnea (sometimes requiring tracheotomy), otitis media, and chronic osteomyelitis with facial fistulas were identified.

Conclusions: Osteopetrosis is a rare condition caused by a failure of the osteoclast to resorb bone. This results in thickened dense, deformed, and easily fractured bone. As a result, growth failure, anemia, hypoplastic dentition, chronic infections, facial fistulas, blindness, hearing loss, nasal congestion, and upper airway obstruction may occur. The management of otolaryngological problems in a child with osteopetrosis is an important component in comprehensive care. To our knowledge, this study represents the largest case series of MIOP in the otolaryngology literature.

Publication types

  • Case Reports

MeSH terms

  • Face
  • Female
  • Fistula / etiology
  • Hearing Loss, Bilateral / etiology
  • Humans
  • Infant
  • Male
  • Osteomyelitis / etiology
  • Osteopetrosis / complications*
  • Otitis Media / etiology
  • Retrospective Studies
  • Sleep Apnea Syndromes / etiology*
  • Sleep Apnea Syndromes / surgery
  • Tracheostomy