Repair of Iatrogenic Temporal Lobe Encephalocele after Canal Wall Down Mastoidectomy in the Presence of Active Cholesteatoma

McMurphy, Andrea Barber; Oghalai, John S.

doi:10.1097/01.mao.0000178119.46290.e1

Cited by 22 publications

(23 citation statements)

References 8 publications

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“…While many agree that chronic otitis media, cholesteatoma, and iatrogenic injury can be potential causes of temporal bone encephaloceles [2,4,6,8], there has been disagreement with regard to the etiology of spontaneous or idiopathic temporal bone encephaloceles [1,7,9,10].…”

Section: Introductionmentioning

confidence: 98%

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Transtemporal management of temporal bone encephaloceles and CSF leaks: Review of 56 consecutive patients

Kari

Mattox

2011

Acta Oto-Laryngologica

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Of the 56 consecutive cases, 12 had CSF otorrhea alone, 19 had encephaloceles, and 23 had both. Two patients presented with spontaneous pneumocephalus without CSF leak. Thirty-three patients had spontaneous onset of their lesion without any history of temporal bone surgery or trauma. The average BMI of patients with spontaneous CSF leaks was found to be greater than the average BMI of patients with CSF leaks due to traumatic, infectious or iatrogenic causes. This difference was found to be statistically significant. Six of these had either preceding or subsequent contralateral mastoid or anterior fossa (sphenoid, ethmoid) CSF leak. Intracranial pressure was evaluated in these cases and most underwent VP shunting to reduce their intracranial pressure. Sixteen cases followed previous mastoid surgery or chronic ear disease and seven were attributed to previous temporal bone trauma. Lesions were repaired with the transtemporal approach (42), middle fossa (4), and combined (5) approaches. Five cases required petrosectomy and fat obliteration. There was one recurrent CSF leak 4 years after initial repair; the leak was anterior to the previously placed bone graft.

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Section: Introductionmentioning

confidence: 98%

“…Previous authors have classified encephaloceles according to their anatomic site of origin [3]. Others have classified them further based on their etiology and management [1,[4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Transtemporal management of temporal bone encephaloceles and CSF leaks: Review of 56 consecutive patients

Kari

Mattox

2011

Acta Oto-Laryngologica

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“…McMurphy and Oghalai (13) reported that CT alone can be misleading in postoperative states. They considered MRI essential for differentiation between granulation tissue, cholesteatoma and brain herniation.…”

Section: Discussionmentioning

confidence: 98%

Diagnosis of recurrent cholesteatoma using diffusion weighted MRI

Ghany

2015

The Egyptian Journal of Radiology and Nuclear Medicine

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Objective: To assess the role of diffusion weighted images (DWI) MRI in differentiating post mastoidectomy recurrent cholesteatoma from infected postoperative granulation tissue. Materials and methods: 13 patients who performed mastoidectomy for previous cholesteatoma that now presented with clinical and CT signs of recurrence were referred to perform non contrast MRI using T2 and DWI sequences in order to differentiate recurrent cholesteatoma from infected postoperative granulation tissue. Results: 8 patients showed MRI evidence of recurrent cholesteatoma, findings were confirmed intra-operative, -ve cases showed good response on medical treatment with regression of their clinical and radiological signs. Conclusion: DWI MRI accurately differentiates recurrent cholesteatoma from infected post operative granulation tissue avoiding unnecessary second look operations.

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“…Although it mostly depends on congenital skull base defects, trauma, infection, and tumours, idiopathic and iatrogenic cases are also encountered [1–4]. They are usually observed in patients who underwent mastoid cavity surgery due to chronic otitis media with or without cholesteatoma [5, 6]. The incidence of encephalocele developed due to tegmen defect is decreased with the use of broad-spectrum antibiotics and technological developments in ear surgeries [5].…”

Section: Introductionmentioning

confidence: 99%

“…They are usually observed in patients who underwent mastoid cavity surgery due to chronic otitis media with or without cholesteatoma [5, 6]. The incidence of encephalocele developed due to tegmen defect is decreased with the use of broad-spectrum antibiotics and technological developments in ear surgeries [5]. Although there is no standard surgery protocol, three approaches are generally acceptable: middle fossa approach, transmastoid approach, and combination of both [3, 5].…”

Section: Introductionmentioning

confidence: 99%

Tegmen Tympani Defect and Brain Herniation Secondary to Mastoid Surgery: Case Presentation

Eğilmez

Hanege

Kalcıoğlu

et al. 2014

Case Reports in Otolaryngology

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Brain herniation into the middle ear is very rarely seen. In addition to reasons like congenital factors, trauma, and infection, tegmen defect may develop as a result of iatrogenic events secondary to chronic otitis media surgery with or without cholesteatoma. Since it may cause life-threatening complications, patients must be evaluated and monitored for tegmen defect. In this paper, diagnosis and treatment of a brain herniation case due to iatrogenic tegmen defect were described along with relevant literature.

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Repair of Iatrogenic Temporal Lobe Encephalocele after Canal Wall Down Mastoidectomy in the Presence of Active Cholesteatoma

Abstract: A temporal lobe encephalocele can be safely repaired while maintaining a mastoid bowl. This may be the safest treatment option for patients with active cholesteatoma.

Cited by 22 publications

References 8 publications

Transtemporal management of temporal bone encephaloceles and CSF leaks: Review of 56 consecutive patients

Transtemporal management of temporal bone encephaloceles and CSF leaks: Review of 56 consecutive patients

Diagnosis of recurrent cholesteatoma using diffusion weighted MRI

Tegmen Tympani Defect and Brain Herniation Secondary to Mastoid Surgery: Case Presentation

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