Middle fossa repair of bilateral large congenital tegmental defects with meningoencephaloceles.
Spontaneous temporal meningoencephaloceles are unusual. When they do occur, they present with a variety of signs and symptoms, which can make diagnosis and management challenging. We report the interesting case of a 49-year-old woman with bilateral congenital temporal meningoencephaloceles. She presented with a 12-month history of bilateral fluctuating hearing loss, and she more recently developed right-sided acute otitis media with meningitis. The presentation of bilateral extensive tegmental defects and meningoencephaloceles with a fluctuating hearing loss and meningitis associated with acute otitis media affecting one ear and then subsequently the other ear is extremely rare and difficult to diagnose. It requires a very careful clinical and radiologic assessment. Methods of surgical repair differ depending on the size of the defects.
Department of ENT, Guy's and St Thomas' Hospitals, 72 Icona Point, Warton Rd, London E15 2LE, UK. aniljoshient@yahoo.com
Anil
A
Joshi
Wendy
W
Smith
David A
DA
Moffat
D004677:Encephalocele / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D008581:Meningitis / Q000209:etiology; D008588:Meningocele / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D010034:Otitis Media with Effusion / Q000209:etiology; D011859:Radiography; D013701:Temporal Bone / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*