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Spontaneous middle-ear encephalocele: report of two cases and brief review
H Alkhalidi1, L N de Tilly, R Fenton
1Department of Laboratory Medicine and Pathobiology, St. Michael's Hospital and Li Ka Shing Knowledge Institute, University of Toronto, Ontario, Canada.
Abstract:
We report two cases of middle-ear spontaneous (idiopathic) encephalocele in patients aged 69 and 82 years. To our knowledge the latter represents the oldest individual reported to have such a lesion. Microscopic examination shows a disorganized neuropil with reactive inflammatory changes and in one case, several cysts lined by simple cylindrical ciliated epithelium. Encephalocele must be included in the differential diagnoses of otorrhea and masses in the middle ear.
Insights
Spontaneous middle-ear encephalocele, a rare condition, was observed in two elderly patients. This finding highlights the importance of considering encephalocele in diagnosing ear masses and otorrhea.
Area of Science:
- Neurology
- Otolaryngology
Background:
- Spontaneous (idiopathic) encephalocele is a rare condition involving brain tissue protrusion through a defect in the skull.
- Middle-ear encephalocele specifically affects the temporal bone, presenting diagnostic challenges.
Observation:
- Two cases of middle-ear encephalocele are presented in patients aged 69 and 82 years.
- The 82-year-old patient represents the oldest reported individual with this condition.
- Microscopic analysis revealed disorganized neuropil with inflammation and cystic changes.
Findings:
- The study documents rare instances of spontaneous middle-ear encephalocele in elderly individuals.
- Histopathological examination identified characteristic neurological and inflammatory changes.
- The presence of ciliated epithelium in one case suggests a potential developmental or acquired component.
Implications:
- Middle-ear encephalocele should be considered in the differential diagnosis of unexplained otorrhea.
- This condition warrants inclusion in the differential diagnosis for middle ear masses, especially in older populations.
- Accurate diagnosis is crucial for appropriate management and to prevent complications.
