title: Brain herniation into the middle ear and mastoid: concepts in diagnosis and surgical management.
abstract: OBJECTIVE
  To review the occurrence characteristics of and clinical repair experience with brain herniation in to the middle ear and mastoid from 1970-1995.
  
  
  METHODS
  Retrospective chart/case review.
  
  
  METHODS
  Private Otology/Neurotology referral practice.
  
  
  METHODS
  Thirty-five patients with temporal bone brain herniation diagnosed and treated from 1970-1995.
  
  
  METHODS
  Diagnosis confirmed by CT and/or MRI. Treatment was surgical.
  
  
  METHODS
  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.
authors.affiliation: Otology Group, Nashville, TN 37203, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Jackson
authors.forename: D G
authors.initials: DG
authors.lastname: Pappas
authors.forename: S
authors.initials: S
authors.lastname: Manolidis
authors.forename: M E
authors.initials: ME
authors.lastname: Glasscock
authors.forename: P G
authors.initials: PG
authors.lastname: Von Doersten
authors.forename: C R
authors.initials: CR
authors.lastname: Hampf
authors.forename: J B
authors.initials: JB
authors.lastname: Williams
authors.forename: I S
authors.initials: IS
authors.lastname: Storper
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D002908:Chronic Disease; D004432:Ear, Middle / Q000473:pathology / Q000601:surgery; D004677:Encephalocele / Q000209:etiology / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed