Brain herniation into the middle ear and mastoid: concepts in diagnosis and surgical management.
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.
Jackson
C G
CG
Otology Group, Nashville, TN 37203, USA.
Pappas
D G
DG
Manolidis
S
S
Glasscock
M E
ME
Von Doersten
P G
PG
Hampf
C R
CR
Williams
J B
JB
Storper
I S
IS
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