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Occult otologic fistulas as a cause of recurrent meningitis

B E Mostafa1, L El Fiky, A Khafagy

  • 1Ain-Shams University, Faculty of Medicine, Cairo, Egypt. bemostafa@entainshams.com

Revue De Laryngologie - Otologie - Rhinologie
|August 6, 2005
PubMed
Abstract

Insights

Occult perilymph fistulas, a cause of unexplained meningitis, can be successfully identified and sealed. Prompt diagnosis and surgical intervention prevent recurrent meningitis and preserve hearing.

Area of Science:

  • Neurology
  • Otolaryngology
  • Neurosurgery

Background:

  • Recurrent meningitis can be caused by occult perilymph fistulas.
  • These fistulas may present with unexplained non-epidemic meningitis.

Observation:

  • Five patients with unexplained meningitis and sensorineural hearing loss underwent CT, MRI, and MRI cisternography.
  • Exploratory tympanotomy was performed to locate and seal suspected fistulas.

Findings:

  • All patients' fistulas were successfully located and sealed.
  • Post-intervention, patients experienced no further meningitis attacks.
  • Hearing in patients with serviceable hearing did not deteriorate further.

Implications:

  • Occult perilymph leaks should be suspected in recurrent meningitis cases, especially with auditory/vestibular symptoms.
  • Early detection and surgical sealing of perilymph fistulas can prevent further meningitis episodes and hearing loss.

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