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Brain herniation into the middle ear and mastoid: concepts in diagnosis and surgical management.
American Journal of Otology 1997 March
OBJECTIVE: To review the occurrence characteristics of and clinical repair experience with brain herniation in to the middle ear and mastoid from 1970-1995.
STUDY DESIGN: Retrospective chart/case review.
SETTING: Private Otology/Neurotology referral practice.
PATIENTS: Thirty-five patients with temporal bone brain herniation diagnosed and treated from 1970-1995.
INTERVENTION: Diagnosis confirmed by CT and/or MRI. Treatment was surgical.
MAIN OUTCOME MEASURES: Success of surgical repair of the problem in a large experience with follow-up of up to 180 months (mean, 48.7 months).
RESULTS: Diagnosis is most effectively made by both (computed tomography (CT) and magnetic resonance imaging (MRI). In this series diagnosis was accurate in 89% with MRI. Primary repair was successful in all but three patients, two of whom required a second repair. One was unreconstructable.
CONCLUSIONS: Temporal bone encephaloceles occur after ear surgery and in chronic otitis media. Prompt and effective surgical repair is successful and integral to complication avoidance.
STUDY DESIGN: Retrospective chart/case review.
SETTING: Private Otology/Neurotology referral practice.
PATIENTS: Thirty-five patients with temporal bone brain herniation diagnosed and treated from 1970-1995.
INTERVENTION: Diagnosis confirmed by CT and/or MRI. Treatment was surgical.
MAIN OUTCOME MEASURES: Success of surgical repair of the problem in a large experience with follow-up of up to 180 months (mean, 48.7 months).
RESULTS: Diagnosis is most effectively made by both (computed tomography (CT) and magnetic resonance imaging (MRI). In this series diagnosis was accurate in 89% with MRI. Primary repair was successful in all but three patients, two of whom required a second repair. One was unreconstructable.
CONCLUSIONS: Temporal bone encephaloceles occur after ear surgery and in chronic otitis media. Prompt and effective surgical repair is successful and integral to complication avoidance.
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