title: Idiopathic temporal bone encephaloceles in the obese patient.
abstract: OBJECTIVE
  Our aims were to introduce temporal bone encephalocele (TBE) to the differential diagnosis of persistent middle ear effusion, cerebrospinal fluid otorrhea, or chronic otitis media in obese adults and to demonstrate the basic pathophysiologic principles of morbid obesity as it may lead to the cascade of increased intra-abdominal pressure, increased central venous pressure, benign increased intracranial pressure, and TBE.
  
  
  METHODS
  A retrospective review of the medical records was performed to determine the location, nature, and etiology of the encephaloceles identified at our institution from 1989 to 2005. Body mass index was calculated from the patient height and weight data.
  
  
  RESULTS
  Eight patients with spontaneous, idiopathic TBE were identified. Body mass index values ranged from 32.0 to 67.5 kg/m(2) with a mean of 48.6 kg/m(2). All patients identified with a spontaneous, idiopathic TBE were obese.
  
  
  CONCLUSIONS
  TBE is associated with morbid obesity in our population and should be considered in the differential diagnosis when evaluating mastoid and middle ear disease in the morbidly obese.
authors.affiliation: Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Penn State University College of Medicine, Hershey, PA 17033, USA. wscurry@psu.edu
authors.forename: W Cooper
authors.initials: WC
authors.lastname: Scurry
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Ort
authors.forename: William M
authors.initials: WM
authors.lastname: Peterson
authors.forename: Jonas M
authors.initials: JM
authors.lastname: Sheehan
authors.forename: Jon E
authors.initials: JE
authors.lastname: Isaacson
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003937:Diagnosis, Differential; D004677:Encephalocele / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications; D012307:Risk Factors; D013701:Temporal Bone / Q000473:pathology / Q000601:surgery*