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Pneumocephalus as a delayed mastoidectomy complication

Published online by Cambridge University Press:  13 February 2007

F Jégoux ,
B Godey ,
L Riffaud  and
X Morandi
F Jégoux
Affiliation:
Department of Otorhinolaryngology, Centre Hospitalier et Universitaire Pontchaillou, Rennes, France
B Godey
Affiliation:
Department of Otorhinolaryngology, Centre Hospitalier et Universitaire Pontchaillou, Rennes, France
L Riffaud
Affiliation:
Department of Neurosurgery, Centre Hospitalier et Universitaire Pontchaillou, Rennes, France.
X Morandi
Affiliation:
Department of Neurosurgery, Centre Hospitalier et Universitaire Pontchaillou, Rennes, France.
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Abstract

We report the case of a 43-year-old woman who presented with a spontaneous pneumocephalus, 37 years after a mastoidectomy. Clinical examination showed a cerebrospinal fluid leak, meningeal herniation in the superior part of the middle ear, and an audible noise from her ear when she stood up due to the entrance of air into the cranium. A computed tomography scan and magnetic resonance imaging showed the complete destruction of the tegmen tympani and the pneumocephalus in the temporal lobe. The patient underwent an emergency operation via a double middle-ear and subtemporal approach. The meningoencephalocoele and pneumocephalus were probably due to long term pressure upon too thin a tegmen tympani.

Pneumocephalus should be considered as a potential delayed post-operative complication of middle-ear surgery. Computed tomography and magnetic resonance imaging scanning supply accurate information and enable a planned surgical approach; they also allow a pathophysiological understanding and a correlation between the clinical signs and the radiological and peri-operative findings.

Keywords

PneumocephalusMeningocoeleEncephalocoeleMastoidSurgical ProceduresOperativeTreatment ComplicationsDiagnostic Imaging
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 121 , Issue 4 , April 2007 , pp. 401 - 403
Copyright
2007 JLO (1984) Limited

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