J Neurol Surg B 2019; 80(04): 424-430
DOI: 10.1055/s-0038-1676036
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Spontaneous Otogenic Pneumocephalus: Case Series and Update on Management

Michael Eggerstedt
1  Department of Otorhinolaryngology, Rush University Medical Center, Chicago, Illinois, United States
,
Scott Hong
2  Rush Medical College, Chicago, Illinois, United States
,
Daniel B. Eddelman
3  Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, United States
,
Ryan M. Smith
1  Department of Otorhinolaryngology, Rush University Medical Center, Chicago, Illinois, United States
,
Lorenzo Munoz
3  Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, United States
,
Rich W. Byrne
3  Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, United States
,
R. Mark Wiet
1  Department of Otorhinolaryngology, Rush University Medical Center, Chicago, Illinois, United States
› Author Affiliations
Further Information

Publication History

09 August 2018

11 October 2018

Publication Date:
19 November 2018 (eFirst)

Abstract

Objectives This study is aimed to report the largest independent case series of spontaneous otogenic pneumocephalus (SOP) and review its pathophysiology, clinical presentation, and treatment.

Design Four patients underwent a middle cranial fossa approach for repair of the tegmen tympani and tegmen mastoideum. A comprehensive review of the literature regarding this disease entity was performed.

Setting U.S. tertiary academic medical center.

Participants: Patients presenting to the lead author's clinic or to the emergency department with radiographic evidence of SOP. Symptoms included headache, otalgia, and neurologic deficits.

Main Outcome Measures Patients were assessed for length of stay, postoperative length of stay, and neurologic outcome. Three of four patients returned to their neurologic baseline following repair.

Results Four patients were successfully managed via a middle cranial fossa approach to repairing the tegmen mastoideum.

Conclusion The middle cranial fossa approach is an effective strategy to repair defects of the tegmen mastoideum. SOP remains a clinically rare disease, with little published information on its diagnosis and treatment.