Simultaneous repair of bilateral temporal bone meningoencephaloceles by combined mastoid-middle cranial fossa approach

Abstract

Meningoencephalocele (MEC) is a rare clinical entity caused by herniation of the dura mater and brain tissue through bony defects in the skull base. We herein report a case of bilateral MECs found after recurrent bacterial meningitis. The patient subsequently underwent simultaneous bilateral resection of the MECs and repair of the lateral skull base using a combined mastoid-middle cranial fossa approach. The bone and dura were reconstructed using free bone grafts and a temporalis fascia flap. Three years after surgery, temporal bone computed tomography showed that the reconstructed tegmen was preserved bilaterally, and there was no recurrence of meningitis or MECs. The appropriate surgical approach should be chosen based on the localization and size of the herniated tissue, and the presence of active infection or other coexisting pathology. Simultaneous bilateral resection using the combined mastoid-middle cranial fossa approach is a promising option for the treatment of bilateral multiple MECs.

Keywords:

• Meningoencephalocele
• otogenic meningitis
• skull base reconstruction

Acknowledgment

The authors thank Angela Morben, DVM, ELS, from Edanz (https://jp.edanz.com/ac), for editing a draft of this manuscript.

Ethical approval

The patients have provided written informed consent forms to the publication of clinical information about them, and the identities of the patients have been protected. This study was conducted in accordance with the ethical standards in the Declaration of Helsinki of 1975 and its amendments or comparable ethical standards.

Informed consent

Authors confirm that consent was obtained from the patients for this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Authors declare no financial supports.