A case of melkersson-rosenthal syndrome presenting with hearing loss

A case of Melkersson-Rosenthal syndrome is reported. The patient, 44-year-old male, presented to our hospital complaining of right-sided hearing loss of one month's duration. Otoscopic examination revealed a presence of effusion in the right middle ear and the patient was diagnosed as having otitis media with effusion (OME). Puretone audiometry showed a moderate degree of mixed hearing loss. However, physical examination at the time of presentation revealed an asymmetrical swelling of the upper lip marked on the right side, right facial weakness with associated movements of a moderate degree and lingua plicata as additional findings. Swellings of both upper and lower gums were also noted. Significant past medical history included rightsided recurrent migraine-like attacks and an episode of transient visual disturbance. Although neither relapse of facial swelling nor recurrence of facial palsy has so far been recognized and histological examination of the upper lip did not necessarily demonstrate the pathognomonic findings of “cheilitis granulomatosa”, those clinical features mentioned above strongly suggested that this case be the complete form of Melkersson-Rosenthal syndrome. Electromyographic findings and results of the blink reflex test were presented, and possible mechanism, topognosis and treatment of the facial palsy associated with this syndrome are discussed.