Fistula between the middle ear and subarachnoid space as a cause of recurrent meningitis: detection by means of thin-section, complex-motion tomography.

Kaseff, Leon G.; Nieberding, Paul H.; Shorago, G W; Huertas, G

doi:10.1148/radiology.135.1.7360945

Cited by 14 publications

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“…When meningitis recurs in the same subject the usual investigations (objective examination, haematochemical tests, lumbar puncture) are insufficient. It is also advisable to carry out a detailed anamnesis to check for previous cranial trauma, even of a limited entity [2], a detailed ear, nose and throat investigation (possible presence of sinusitis, mastoiditis, or Mondini's syndrome [6,13], and a complete immunological evaluation [3,14,15,17,18]. The use of radiological investigations (cranial X-ray, computed tomography) preceded if necessary by an echographic or radioisotopic examination [4,9,11], should be taken into consideration in every case, in order to establish the most suitable form of treatment.…”

Section: And Immunologicalmentioning

confidence: 99%

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Recurrent meningitis: a case report

et al. 1989

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A 25-month-old girl is described who experienced three successive attacks of purulent meningitis due to Proteus mirabilis. Third generation cephalosporins were employed as treatment. Cranial radiography and computed tomography revealed a malformation, in the form of an epidermoid cyst, in a central occipital position; small cerebellar abscesses were also present. The lesion was removed by surgery which led to a complete recovery.

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Section: And Immunologicalmentioning

confidence: 99%

“…Other important factors include conditions of the ear, nose and throat [1, 2,6,7,13], congenital malformations [2,5,10,16] …”

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confidence: 99%

Recurrent meningitis: a case report

et al. 1989

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Spontaneous Meningoencephalocele of the Temporal Bone

Nahas¹,

Tatlipinar²,

Limb³

et al. 2008

Arch Otolaryngol Head Neck Surg

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To describe the clinical presentation and the radiological and surgical findings in patients with spontaneous meningoencephalocele of the temporal bone. Design: Retrospective case series. Setting: Academic, tertiary care medical center. Patients: Fifteen consecutive patients with surgically confirmed meningoencephalocele of the mastoid and middle ear, without a history of trauma, tumor, cholesteatoma, or surgery of the mastoid or cranium, who were treated at our institution between January 1, 1999, and December 31, 2006. Results: Ten of the 15 patients were women. Ages ranged from 31 to 77 years, with 12 patients 50 years or older. The most common presenting complaint was newonset hearing loss in 14 patients, followed by aural fullness and headache. Cerebrospinal fluid formed an effusion in the middle ears of 13 patients and was most commonly identified when myringotomy resulted in continuous clear otorrhea. Four subjects had a history of adult-onset recurrent acute otitis media with intermittent otorrhea, which in 1 case was complicated by brain abscess. At least 1 full-thickness defect of the tegmen associated with cortical thinning of the middle fossa floor was identified in all cases on high-resolution computed tomography. At surgery, herniations of meningeal and cerebral tissue were seen through 1 (7 cases) or 2 (8 cases) defects in the middle fossa floor. Obstruction of antral aeration by the meningoencephalocele was present in all 4 cases associated with otitis media.

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Recurrent Meningitis and Mondini Dysplasia

Ohlms

Edwards

Mason

et al. 1990

Archives of Otolaryngology - Head and Neck Surgery

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Three infants with cerebrospinal fluid otorrhea and recurrent meningitis due to Mondini dysplasia have been treated at Baylor College of Medicine, Houston, Tex; 39 other patients with this association have been described. This review highlights the characteristics and embryologic basis of the malformation. The clinical evaluation of an infant with recurrent meningitis is outlined, and the importance of brain-stem response audiometry and thin-cut computed tomography of the temporal bones is discussed. Surgical management depends on the functional status of the dysplastic ear; usually, a stapedectomy is performed and the vestibule is obliterated. Although the surgical failure rate is 30% after one procedure, early identification of the dysplasia and prompt surgical management diminish morbidity and mortality and permit early habilitation of the child with congenital hearing impairment.

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Fistula between the middle ear and subarachnoid space as a cause of recurrent meningitis: detection by means of thin-section, complex-motion tomography.

Cited by 14 publications

References 0 publications

Recurrent meningitis: a case report

Recurrent meningitis: a case report

Spontaneous Meningoencephalocele of the Temporal Bone

Recurrent Meningitis and Mondini Dysplasia

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