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Spontaneous Otogenic Pneumocephalus: Case Series and Update on Management.
Michael Eggerstedt1, Scott Hong2, Daniel B Eddelman3
1Department of Otorhinolaryngology, Rush University Medical Center, Chicago, Illinois, United States.
Journal of Neurological Surgery. Part B, Skull Base
|July 19, 2019
Summary
Spontaneous otogenic pneumocephalus (SOP) is rare. Surgical repair of tegmen tympani and mastoideum defects using a middle cranial fossa approach effectively managed four patients, restoring neurologic function.
Area of Science:
- Neurosurgery
- Otolaryngology
- Radiology
Background:
- Spontaneous otogenic pneumocephalus (SOP) is a rare condition characterized by intracranial air accumulation secondary to inner ear or mastoid pathology.
- Limited case series and literature exist regarding the diagnosis and management of SOP.
Purpose of the Study:
- To present the largest independent case series of SOP.
- To review the pathophysiology, clinical presentation, and treatment of SOP.
- To evaluate the efficacy of the middle cranial fossa approach for SOP repair.
Main Methods:
- Retrospective case series of four patients with SOP.
- Surgical repair utilizing a middle cranial fossa approach for tegmen tympani and tegmen mastoideum defects.
- Comprehensive literature review on SOP.
Main Results:
- Four patients with SOP were successfully treated with a middle cranial fossa approach.
- Surgical repair addressed defects in the tegmen tympani and tegmen mastoideum.
- Three of four patients achieved full neurologic recovery.
Conclusions:
- The middle cranial fossa approach is an effective surgical strategy for repairing tegmen mastoideum defects in SOP.
- SOP is a rare entity requiring further investigation into its optimal diagnosis and treatment protocols.
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