Iatrogenic Temporal Encephalocele Managed by Combined Transmastoid and Middle Cranial Fossa Approach / 대한이비인후과학회지

ABSTRACT

Herniation of the brain into the middle ear or mastoid is a rare but potentially life-threatening complication of chronic otitis media with or without cholesteatoma. The advent of antibiotic therapy and microsurgical techniques has greatly lowered the incidence of brain herniation but this complication still occurs, with potential devastating sequelae. Because of the non specificity of the clinical signs and symptoms, brain herniation is often discovered incidentally at the time of surgery for chronic otitis media. The patient was a 56-year-old female who had a history of tympanomastoid surgery for right ear about 7 years ago and had complained of intermittent ipsilateral pain in the postauricular area and progressive hearing disturbance. Preoperative imaging studies suggested a temporal encephalocele with infected middle ear and mastoid cavity. The patient underwent a repair of the temporal encephalocele and a revision tympanomastoidectomy using the combined transmastoid and middle cranial fossa approach.