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Otitic meningitis, superior semicircular canal dehiscence, and encephalocele: a case series

Zixiang Michael Lim1, Peter Leon Friedland, Rudolf Boeddinghaus

  • 1Department Otolaryngology-Head Neck and Skull Base Surgery, Sir Charles Gairdner Hospital, Ear Science Centre, The University of Western Australia, Nedlands WA 6009, Australia. michaellim24@ymail.com

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|April 25, 2012
PubMed
Abstract

Insights

This study highlights the critical link between Superior Semicircular Canal Dehiscences (SSCD), encephaloceles, and otitic meningitis. Prompt diagnosis and surgical intervention for SSCD with associated defects can prevent serious meningitis complications.

Area of Science:

  • Neuroscience
  • Otolaryngology
  • Infectious Disease

Background:

  • Otitic meningitis remains a severe condition despite antibiotics, necessitating prompt treatment of predisposing factors.
  • Asymptomatic middle cranial fossa encephaloceles and Superior Semicircular Canal Dehiscences (SSCD) present diagnostic and management challenges.
  • The co-occurrence of otitic meningitis, SSCD, and encephaloceles is rarely documented.

Observation:

  • A series of 4 patients presented with a combination of otitic meningitis, encephaloceles, and SSCD.
  • Computed tomography confirmed SSCD with ipsilateral tegmen tympani defects and associated encephaloceles in all patients with meningitis secondary to otitis media.

Findings:

  • All patients required intensive care, significant morbidity, and prolonged hospitalization despite antibiotic and surgical interventions (myringotomy, mastoidectomy, abscess drainage).
  • No mortalities were reported in this series.

Implications:

  • Recommend computed tomography of the cranial base for all SSCD patients to identify associated tegmen tympani defects.
  • Support elective surgical repair for SSCD with asymptomatic ipsilateral encephaloceles to mitigate the risk of otitic meningitis.

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