Persistent Cerebrospinal Fluid Otorrhea

Gm, Hall; Oe, Hallberg

doi:10.1001/archotol.1967.00760050379005

Cited by 21 publications

(3 citation statements)

References 9 publications

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“…Some previous reports describe that PAC may produce the clinical manifestation related to a CSF fistula. 1 , 4 , 11 , 12 , 13 The lesion triggered a CSF fistula in these patients when a tear occurred in the cyst wall, allowing CSF to leak into the petrous apex. PAC of our patient may be the possible source of the CSF leak.…”

Section: Discussionmentioning

confidence: 99%

Unilateral expanding petrous apex cephalocele and contralateral vitreous hemorrhage in a young patient with intracranial hypertension

Hanai

Hashimoto

Nakamura

2022

American Journal of Ophthalmology Case Reports

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Purpose To report a case of unilateral petrous apex cephalocele (PAC) and contralateral vitreous hemorrhage in a young patient with intracranial hypertension. Observations A 12-year-old boy had acute visual loss in the right eye. The clinical and radiological findings were consistent with right vitreous hemorrhage with mild intracranial hypertension and left PAC. Cerebral angiography demonstrated low flow of the left inferior petrosal sinus and anterior venous high flow from the cavernous sinus to the facial vein via the superior ophthalmic vein. The presence of an expanding PAC, blocking the venous flow away from the inferior petrosal sinus, would produce an ipsilateral intraocular pressure (IOP) (20 mmHg) mildly higher than the other one (16 mmHg) although it is in the normal range, which may have caused the difference of the translaminar pressure gradient resulting from the balance between the cerebrospinal flow pressure and the IOP. Conclusion and Importance Unilateral expanding PAC may cause intracranial hypertension with different severity of papilledema between two eyes.

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Section: Discussionmentioning

confidence: 99%

Unilateral expanding petrous apex cephalocele and contralateral vitreous hemorrhage in a young patient with intracranial hypertension

Hanai

Hashimoto

Nakamura

2022

American Journal of Ophthalmology Case Reports

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“…All patients with a clinical history consistent with CSF otorrhoea should have an otological and audiometric assessment even though the associated fracture may have healed spontaneously and the leak sealed (Hall et al, 1967). Even with an intact eardrum and a dry ear, a conductive hearing loss from ossicular disruption may exist and hearing may be restored by elective surgery.…”

Section: Discussionmentioning

confidence: 99%

Tegmental dehiscence and brain herniation into the middle ear cleft

Golding-Wood¹,

Williams²,

Brookes³

1991

J. Laryngol. Otol.

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The tegmen tympani may occasionally be breached by herniation of the temporal lobe with or without dural cover. The clinical presentation may be obvious with CSF otorrhoea but less so with apparent middle ear effusion, CSF rhinnorrhoea, conductive hearing loss, recurrrent meningitis or intracranial sepsis. Diagnosis requires suspicion of the condition, which may be aided by radiological imaging. Surgical repair is to be recommended: various techniques are available but bone enveloped by fascia placed by subtemporal approach is preferred. The features of this problem are highlighted by four cases.

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“…Alberti and Dawes (1961) recommend that defects in the tegmen should be repaired via the middle fossa, and those in Trautman's triangle via the mastoid using temporalis fascia or muscle. A temporalis pedicle into the mastoid is used by George Hall et al (1967) and by Dedo and Sooy (1970) if the external canal wall is intact. If there is an open cavity, the latter authors simply recommend packing of the mastoid for six weeks with iodoform after removal of the hernia flush with the dura.…”

Section: Discussionmentioning

confidence: 99%