Management of meningoencephalocele herniation of temporal bone with five layer repair in a tertiary care centre

Document Type : Case Reports

Authors

1 Department of ENT Kasturba Medical College, Manipal, Karnataka, India

2 Department of ENT Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India

3 Department of Paediatrics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India

Abstract

Meningoencephaloceles of the temporal bone are rare and often misdiagnosed, posing a diagnostic and surgical challenge for the otorhinolaryngologist. Etiologies like chronic otitis media, head trauma, or previous surgical procedures involving the temporal bone can lead to it.Life threatening complications like meningitis, encephalitis, and cerebral abscesses can be prevented by early surgical intervention.
Case presentation
In a pediatric case discussed in this report, the tegmen breach was a result of post-operative iatrogenic cause after being operated for chronic otitis media pathology and was subsequently surgically reduced and repaired in five layers using trans mastoid approach. The patient improved clinically and post-operative computed tomography and pure tone audiogram showed improvement in hearing on subsequent follow ups.
Conclusion
A holistic approach with timely diagnosis, appropriate radiological assessment to visualise the defect and early surgical intervention with transmastoid approach ensuring multilayer closure are key factors in improving the outcome in patients with meningoencephalocele

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