ABSTRACT
A meningocele is a protrusion of meninges through a defect in the skull base. It is a rare but potentially life-threatening condition requiring surgery. It can present with conductive hearing loss, persistent middle ear effusion, cerebrospinal fluid otorrhea, recurrent meningitis, and epilepsy. We report a patient who presented with a three-year history of intermittent pulsatile tinnitus in her left ear. She had clear middle ear effusion and radiological evaluations suggesting an attic cholesteatoma. She underwent a tympanomastoidectomy and we discovered a meningocele in the epitympanum and a bony defect of the tegmen tympani. We easily restored the meningocele using a microelevator and bolstered the bone with temporalis fascia, conchal cartilage and musculoperiosteal flap. There was no evidence of cerebrospinal fluid leakage and the patient's tinnitus disappeared six months after the operation.
Subject(s)
Humans , Cartilage , Cerebrospinal Fluid Otorrhea , Cholesteatoma , Ear , Epilepsy , Fascia , Hearing Loss, Conductive , Meninges , Meningitis , Meningocele , Otitis Media with Effusion , Skull Base , Temporal Bone , TinnitusABSTRACT
Concha bullosa is a common anatomic variation of the middle turbinate; however, sinusitis secondary to the concha bullosa is rare. A 52-yr-old woman presented with nasal obstruction and posterior nasal drip. Computed tomography and examination of the nasal cavity revealed septal deviation on the left side, and a massive concha bullosa and maxillary sinusitis on the right side. The lateral lamella of the affected turbinate was removed and the inspissated material was drained. Histopathologic examination of the excised lesion in the concha bullosa revealed bacterial colonies in the mucus plug. We report here on a massive concha bullosa with secondary maxillary sinusitis.