Osteopetrosis of temporal bone causing bilateral peripheral facial nerve paralysis: MRI and CT findings

Osteopetrosis is a rare, heterogeneous group of genetic disorders characterized by osteoclast dysfunction, resulting in excessive bone sclerosis. When it affects the skull base and temporal bone, it can lead to Eustachian tube dysfunction, recurrent otitis media, hearing impairment, and cranial nerve deficits. This report highlights the computed tomography (CT) and magnetic resonance imaging (MRI) findings of temporal bone osteopetrosis in an 18-year-old male presenting with acute-onset bilateral facial nerve paralysis. Radiological evaluation revealed significant narrowing of the bilateral internal acoustic canals, a hallmark feature of the disease. The patient received a short course of corticosteroid therapy, resulting in complete resolution of symptoms. This case underscores the critical role of imaging in diagnosing and managing cranial nerve complications in temporal bone osteopetrosis.