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Tegmental dehiscence and brain herniation into the middle ear cleft

1991; Cambridge University Press; Volume: 105; Issue: 6 Linguagem: Inglês

10.1017/s0022215100116354

1748-5460

David Golding‐Wood, Helen Williams, Gerald B. Brookes,

Meningioma and schwannoma management

Abstract The tegmen tympani may occasionally be breached by herniation of the temporal lobe with or without dural cover. The clinical presentation may be obvious with CSF otorrhoea but less so with apparent middle ear effusion, CSF rhinnorrhoea, conductive hearing loss, recurrrent meningitis or intracranial sepsis. Diagnosis requires suspicion of the condition, which may be aided by radiological imaging. Surgical repair is to be recommended: various techniques are available but bone enveloped by fascia placed by subtemporal approach is preferred. The features of this problem are highlighted by four cases.