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[Epidural abscess and encephalocele following tegmen defect due to mastoidectomy: a case report]
Hatice Emir1, Zeynep Kizilkaya Kaptan, Hakan Göçmen
1Department of Otolaryngology, Ankara Training and Research Hospital, Ankara, Turkey. emir.hatice@gmail.com.
Abstract:
In chronic otitis media surgery, especially in cases with cholesteatoma, different complications can occur in the course of the operation or postoperatively. In our clinic, in one of the cases who had staged canal-wall down operation for otitis media with cholesteatoma, an iatrogenic 0.5x0.5 cm dural plate defect had occurred in tegmen tympani during the operation. In this article, we present an uncommon case who had encephalocele with epidural abscess because of unrepaired dural plate defect superimposed with early postoperative infection at the first month after the operation and we discuss it in the light of the literature.
Insights
A rare complication of chronic otitis media surgery, encephalocele with epidural abscess, occurred due to an unrepaired dural plate defect following a canal-wall down operation for cholesteatoma.
Area of Science:
- Otolaryngology
- Neurosurgery
- Infectious Disease
Background:
- Chronic otitis media with cholesteatoma often requires surgical intervention.
- Canal-wall down tympanomastoidectomy is a common surgical approach.
- Potential complications include dural plate defects and subsequent infections.
Observation:
- A patient undergoing staged canal-wall down surgery for cholesteatoma developed an iatrogenic 0.5x0.5 cm dural plate defect in the tegmen tympani.
- The dural defect was not repaired during the initial surgery.
- The patient presented with encephalocele and epidural abscess within one month postoperatively.
Findings:
- An unrepaired dural plate defect can lead to encephalocele.
- Postoperative infection can exacerbate complications from dural defects.
- Encephalocele with epidural abscess is a rare but serious complication.
Implications:
- Highlights the critical importance of meticulous surgical technique in preventing dural injuries.
- Underscores the need for prompt recognition and management of dural defects.
- Emphasizes the potential for severe intracranial complications following otologic surgery.
