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DOI: 10.1055/s-2007-986429
© Thieme Medical Publishers
Idiopathic Temporal Bone Encephalocele
Publication History
Publication Date:
07 September 2007 (online)
ABSTRACT
Meningoencephaloceles are herniations of brain tissue through dehiscences of the skull base. These skull defects are either acquired (otologic infection, trauma, surgery, neoplasia) or spontaneous. Spontaneous temporal bone meningoencephaloceles are quite rare conditions, usually congenital in origin presenting during childhood, and only occasionally idiopathic presenting during adulthood. We present a case of temporal bone meningoencephalocele of adult onset. The patient was treated with exploratory mastoidectomy, amputation of the herniated cele and closure of the defect with temporalis fascia and an inferiorly based pedicled muscular flap. No reconstruction of the bony defect was performed, as the layered closure was considered adequate. Twelve months' follow-up revealed no relapse of the condition or postoperative complications.
KEYWORDS
Temporal bone - meningoencephalocele - brain herniation
REFERENCES
- 1 Jackson C G, Pappas Jr D G, Manolidis S et al.. Brain herniation into the middle ear and mastoid: concepts in diagnosis and surgical management. Am J Otol. 1997; 18 198-205 discussion 205-206
- 2 MacRae D L, Ruby R F. Recurrent meningitis secondary to perilymph fistula in young children. J Otolaryngol. 1990; 19 222-225
- 3 Phillipps J J. Bilateral oval window fistulae with recurrent meningitis. J Laryngol Otol. 1986; 100 329-331
- 4 Quiney R E, Mitchell D B, Djazeri B, Evans J G. Recurrent meningitis in children due to inner ear abnormalities. J Laryngol Otol. 1989; 103 473-480
- 5 Barr B, Wersall J. Cerebrospinal otorrhea with meningitis in congenital deafness. Arch Otolaryngol. 1965; 81 26-28
- 6 Bennett R J. On subarachnoid-tympanic fistulae: a report of two cases of the rare indirect type. J Laryngol Otol. 1966; 80 1242-1252
- 7 Biggers W P, Howell N N, Fisher N D, Himadi G M. Congenital ear anomalies associated with otic meningitis. Arch Otolaryngol. 1973; 97 399-401
- 8 Tschiang H H, Harrison M S, Ozsahinaglu C A. Cerebro-spinal otorrhoea. J Laryngol Otol. 1973; 87 475-483
- 9 Weider D J, Geurkink N A, Saunders R L. Spontaneous cerebrospinal fluid otorhinorrhea. Am J Otol. 1985; 6 416-422
- 10 Schick B, Draf W, Kahle G, Weber R, Wallenfang T. Occult malformations of the skull base. Arch Otolaryngol Head Neck Surg. 1997; 123 77-80
- 11 Kapur T R, Bangash W. Tegmental and petromastoid defects in the temporal bone. J Laryngol Otol. 1986; 100 1129-1132
- 12 Ahren C, Thulin C A. Fatal intracranial complications due to politzerization of the outer ear canal in otitis therapy, caused by intracranial temporal bone defects. Sven Lakartidn. 1964; 61 2421-2437
- 13 Kamerer D B, Caparosa R J. Temporal bone encephalocele: diagnosis and treatment. Laryngoscope. 1982; 92 878-882
- 14 Kaseff L G, Seidenwurm D J, Nieberding P H, Nissen A J, Remley K R, Dillon W. Magnetic resonance imaging of brain herniation into the middle ear. Am J Otol. 1992; 13 74-77
- 15 Mosnier I, Fiky L E, Shahidi A, Sterkers O. Brain herniation and chronic otitis media: diagnosis and surgical management. Clin Otolaryngol Allied Sci. 2000; 25 385-391
- 16 Kaufman B, Yonas H, White R J, Miller C F. Acquired middle cranial fossa fistulas: normal pressure and nontraumatic in origin. Neurosurgery. 1979; 5 466-472
- 17 Ommaya A K. Cerebrospinal fluid rhinorrhea. Neurology. 1964; 14 106-113
- 18 Sckunecht H F, Gulya A J. Anatomy of the Temporal Bone with Surgical Implication. Philadelphia, PA; Lea & Febiger 1986: 125-126
- 19 Gacek R R. Arachnoid granulation cerebrospinal fluid otorrhea. Ann Otol Rhinol Laryngol. 1990; 99 854-862
- 20 Gacek R R. Evaluation and management of temporal bone arachnoid granulations. Arch Otolaryngol Head Neck Surg. 1992; 118 327-332
-
21 Lalwani A K.
Temporal bone encephalocele . In: Jackler RK, Brackman DE Neurotology. St. Louis, MO; Mosby 2004: 1089-1095 - 22 Lundy L B, Graham M D, Kartush J M, LaRouere M J. Temporal bone encephalocele and cerebrospinal fluid leaks. Am J Otol. 1996; 17 461-469
- 23 Kale S U, Pfleiderer A G, Cradwick J C. Bilateral defects of the tegmen tympani associated with brain and dural prolapse in a patient with pulsatile tinnitus. J Laryngol Otol. 2000; 114 861-863
- 24 Pappas Jr D G, Hoffman R A, Cohen N L, Pappas Sr D G. Spontaneous temporal bone cerebrospinal fluid leak. Am J Otol. 1992; 13 534-539
- 25 Sdano M T, Pensak M L. Temporal bone encephaloceles. Curr Opin Otolaryngol Head Neck Surg. 2005; 13 287-289
- 26 Skedros D G, Cass S P, Hirsch B E, Kelly R H. Beta-2 transferrin assay in clinical management of cerebral spinal fluid and perilymphatic fluid leaks. J Otolaryngol. 1993; 22 341-344
- 27 Mafee M F, Kumar A, Yannias D A, Valvassori G E, Applebaum E L. Computed tomography of the middle ear in the evaluation of cholesteatomas and other soft tissue masses: comparison with pluridirectional tomography. Radiology. 1983; 148 465-472
- 28 Ishii K, Takahashi S, Matsumoto K et al.. Middle ear cholesteatoma extending into the petrous apex: evaluation by CT and MR imaging. AJNR Am J Neuroradiol. 1991; 12 719-724
- 29 Liu D P, Bergeron R T. Contemporary radiologic imaging in the evaluation of middle ear-attic-antral complex cholesteatomas. Otolaryngol Clin North Am. 1989; 22 897-909
- 30 Raine C. Diagnosis and management of otologic cerebrospinal fluid leak. Otolaryngol Clin North Am. 2005; 38 583-595
-
31 Graham M D, Lundy L B.
Dural herniation and cerebrospinal fluid leaks . In: Brackmann DE, Shelton C, Arriaga M Otologic Surgery. Philadelphia, PA; WB Saunders 1993: 277-288 - 32 Glasscock III M E, Dickins J R, Jackson C G, Wiet R J, Feenstra L. Surgical management of brain tissue herniation into the middle ear and mastoid. Laryngoscope. 1979; 89 1743-1754
- 33 Jahrsdoerfer R A, Richtsmeier W J, Cantrell R W. Spontaneous CSF otorrhea. Arch Otolaryngol. 1981; 107 257-261
- 34 Ramsden R T, Latif A, Lye R H, Dutton J E. Endaural cerebral hernia. J Laryngol Otol. 1985; 99 643-651
- 35 Dedo G G, Sooy F A. Endaural encephalocele and cerebrospinal fluid otorrhea. Ann Otol Rhinol Laryngol. 1970; 79 168-177
-
36 Lalwani A K.
Temporal bone encephalocele . In: Jackler RK, Brackman DE Neurotology. St. Louis, MO; Mosby 2004: 1089-1095 - 37 Neely J G, Neblett C R, Rose J. Diagnosis and treatment of spontaneous cerebrospinal fluid otorrhea. Laryngoscope. 1982; 92 609-612
- 38 Wootten C T, Kaylie D M, Warren F M, Jackson C G. Management of brain herniation and cerebrospinal fluid leak in revision chronic ear surgery. Laryngoscope. 2005; 115 1256-1261
- 39 Kuhweide R, Casselman J W. Spontaneous cerebrospinal fluid otorrhea from a tegmen defect: transmastoid repair with minicraniotomy. Ann Otol Rhinol Laryngol. 1999; 108 653-658
- 40 Valtonen H, Geyer C, Tarlov E, Heilman C, Poe D. Tegmental defects and cerebrospinal fluid otorrhea. ORL J Otorhinolaryngol Relat Spec. 2001; 63 46-52
- 41 Savva A, Taylor M J, Beatty C W. Management of cerebrospinal fluid leaks involving the temporal bone: report on 92 patients. Laryngoscope. 2003; 113 50-56
- 42 Dandy W E. Treatment of rhinorrhea and otorrhea. Arch Surg. 1944; 49 779-788
- 43 Canfeield R B. Some conditions associated with the loss of cerebrospinal fluid. Ann Otol Rhinol Laryngol. 1913; 22 604-622
- 44 Paparella M M, Meyerhoff W L, Oliviera C A. Mastoiditis and brain hernia (mastoiditis cerebri). Laryngoscope. 1978; 88 1097-1106
- 45 Rathore M H. Do prophylactic antibiotics prevent meningitis after basilar skull fracture?. Pediatr Infect Dis J. 1991; 10 87-88
- 46 Friedman J A, Ebersold M, Quast L M. Post-traumatic cerebrospinal fluid leakage. World J Surg. 2001; 25 1062-1066
- 47 Ignelzi R J, VanderArk G D. Analysis of the treatment of basilar skull fractures with and without antibiotics. J Neurosurg. 1975; 43 721-726
- 48 Eljamel M S. Antibiotic prophylaxis in unrepaired CSF fistulae. Br J Neurosurg. 1993; 7 501-505
A. BibasM.Sc.
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