Korean J Otorhinolaryngol-Head Neck Surg.  2011 Apr;54(4):308-311. 10.3342/kjorl-hns.2011.54.4.308.

Surgical Treatment of Spontaneous Meningocele of the Temporal Bone Causing a Pulsatile Tinnitus

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea. kcw5088@dreamwiz.com

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.

Keyword

Meningocele; Pulsatile tinnitus; Temporal bone

MeSH Terms

Cartilage
Cerebrospinal Fluid Otorrhea
Cholesteatoma
Ear
Epilepsy
Fascia
Hearing Loss, Conductive
Humans
Meninges
Meningitis
Meningocele
Otitis Media with Effusion
Skull Base
Temporal Bone
Tinnitus
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