Search tips
Search criteria 


Logo of skullbasesurgInstructions for AuthorsSubscribe to Skull BaseAbout Skull BaseEditorial BoardThieme Medical PublishingSkull Base An Interdisciplinary Approach ...
Skull base surgery. 1996 July; 6(3): 193–197.
PMCID: PMC1656568

A Method of Treatment for Persisting Cerebellar Encephalocele of the Temporal Bone


Temporal lobe herniation or meningoencephaloceles through the tegmen bone are rare entities but are well-described lesions in the literature. They can be successfully approached through the middle fossa alone or combined with a transmastoid approach, and are repaired with fascia, bone, or cartilage. However, cerebellar encephaloceles penetrating the posterior fossa dural plate and presenting as pulsatile postauricular mass are rare. In this paper, we report successful treatment of a cerebellar encephalocele by cranialization of the mastoid cavity using a calvarial bone graft and closure of the external auditory canal. A prior suboccipital approach, as recommended by others, had failed. The patient has remained well for 1 year with no recurrence.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.5M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Ramanikanth TV, Smith MC, Ramamoorthy R, Ramalingam KK. Postauricular cerebellar encephalocoele secondary to chronic suppurative otitis media and mastoid surgery. J Laryngol Otol. 1990 Dec;104(12):982–985. [PubMed]
  • David DJ, Simpson DA. Frontoethmoidal meningoencephaloceles. Clin Plast Surg. 1987 Jan;14(1):83–89. [PubMed]
  • SCHURR PH. Endaural cerebral hernia. Br J Surg. 1960 Jan;47:414–417. [PubMed]
  • Gacek RR. Arachnoid granulation cerebrospinal fluid otorrhea. Ann Otol Rhinol Laryngol. 1990 Nov;99(11):854–862. [PubMed]
  • Bowes AK, Wiet RJ, Monsell EM, Hahn YS, O'Connor CA. Brain herniation and space-occupying lesions eroding the tegmen tympani. Laryngoscope. 1987 Oct;97(10):1172–1175. [PubMed]
  • Kemink JL, Graham MD, Kartush JM. Spontaneous encephalocele of the temporal bone. Arch Otolaryngol Head Neck Surg. 1986 May;112(5):558–561. [PubMed]
  • Graham MD. Surgical management of dural and temporal lobe herniation into the radical mastoid cavity. Laryngoscope. 1982 Mar;92(3):329–331. [PubMed]
  • Neely JG, Neblett CR, Rose JE. Diagnosis and treatment of spontaneous cerebrospinal fluid otorrhea. Laryngoscope. 1982 Jun;92(6 Pt 1):609–612. [PubMed]
  • Dedo GG, Sooy FA. Endaural encephalocele and cerebrospinal fluid otorrhea. Ann Otol Rhinol Laryngol. 1970 Feb;79(1):168–177. [PubMed]
  • Linstrom CJ, Krajewski MJ, Shapiro AL, Caruana S. Outer table graft in middle fossa surgery. Otolaryngol Head Neck Surg. 1994 Jul;111(1):70–75. [PubMed]
  • Kaseff LG, Seidenwurm DJ, Nieberding PH, Nissen AJ, Remley KR, Dillon W. Magnetic resonance imaging of brain herniation into the middle ear. Am J Otol. 1992 Jan;13(1):74–77. [PubMed]
  • Ferguson BJ, Wilkins RH, Hudson W, Farmer J., Jr Spontaneous CSF otorrhea from tegmen and posterior fossa defects. Laryngoscope. 1986 Jun;96(6):635–644. [PubMed]
  • Golding-Wood DG, Williams HO, Brookes GB. Tegmental dehiscence and brain herniation into the middle ear cleft. J Laryngol Otol. 1991 Jun;105(6):477–480. [PubMed]
  • Arìstegui M, Falcioni M, Saleh E, Taibah A, Russo A, Landolfi M, Sanna M. Meningoencephalic herniation into the middle ear: a report of 27 cases. Laryngoscope. 1995 May;105(5 Pt 1):512–518. [PubMed]
  • Kamerer DB, Caparosa RJ. Temporal bone encephalocele--diagnosis and treatment. Laryngoscope. 1982 Aug;92(8 Pt 1):878–882. [PubMed]
  • Briant TD, Bird R. Extracranial repair of cerebrospinal fluid fistulae. J Otolaryngol. 1982 Jun;11(3):191–197. [PubMed]
  • Schuknecht HF, Zaytoun GM, Moon CN., Jr Adult-onset fluid in the tympanomastoid compartment. Diagnosis and management. Arch Otolaryngol. 1982 Dec;108(12):759–765. [PubMed]
  • Jackson IT, Helden G, Marx R. Skull bone grafts in maxillofacial and craniofacial surgery. J Oral Maxillofac Surg. 1986 Dec;44(12):949–955. [PubMed]

Articles from Skull Base Surgery are provided here courtesy of Thieme Medical Publishers