[Post-surgical and post-infectious meningoencephalic herniation in the middle ear]

Meningoencephalic hernia of the middle ear, due to the advent of antibiotics, the surgical microscope, and the new surgical techniques for the treatment of chronic otitis media, is an infrequent pathology in the presents days. The goal of this paper is to present four cases of meningoencephalic hernia of the middle ear, three of then postsurgical and the remaining of inflammatory origin. Diagnosis, treatment and complications are discussed. Meningoencephalic hernia of the middle ear is usually asymptomatic and diagnosis is accidental. Immediate surgical treatment is indicated in order to avoid the potential complications of this disease. Transmastoid approach has been used for three cases and a middle cranial fossa approach was used in the fourth patient.