| Radiographic diagnosis of trans-stapedial cerebrospinal fluid fistula. | |
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MedLine Citation:
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PMID: 20416458 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To report the high-resolution computed tomography and magnetic resonance imaging (MRI) findings of a bulging oval window in children with recurrent meningitis and congenital cerebrospinal fluid fistula. STUDY DESIGN: Case series. SETTING: Academic medical center children's hospital. SUBJECTS AND METHODS: A series of eight ears in four children with profound, bilateral sensorineural hearing loss and perilymphatic hydrops were evaluated. Two patients presented with recurrent meningitis. All children were assessed with high-resolution computed tomography, and two children also underwent MRI. RESULTS: Seven of eight ears had a common cavity malformation. The vestibular compartment showed severe dysplasia (n = 5), moderate dysplasia (n = 1), or a single semicircular canal (n = 2). The lamina cribrosa was clearly absent in four of eight ears. Its presence was difficult to assess in ears with small internal auditory canals. A bulging oval window, present in six of eight ears, was defined as a fluid density on high-resolution computed tomography or a hyperintense mass demonstrated by T2-weighted MRI protruding from the vestibule into the middle ear cavity. When present, this herniation of a fluid-filled sac could be seen on both MRI and computed tomography. This imaging finding was surgically confirmed in two patients. CONCLUSION: The bulging oval window, which represents a fluid-filled sac, can be identified by both high-resolution computed tomography and MRI. Communication between the middle ear and the subarachnoid space through the inner ear is an important etiology for recurrent meningitis in children with sensorineural hearing loss. |
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Authors:
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Dale R Ehmer; Timothy Booth; J Walter Kutz; Peter S Roland |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2010-03-03 |
Journal Detail:
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Title: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery Volume: 142 ISSN: 1097-6817 ISO Abbreviation: Otolaryngol Head Neck Surg Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-26 Completed Date: 2010-05-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8508176 Medline TA: Otolaryngol Head Neck Surg Country: United States |
Other Details:
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Languages: eng Pagination: 694-8 Citation Subset: IM |
Copyright Information:
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Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Otolaryngology-Head & Neck Surgery, UT Southwestern Medical Center at Dallas, Dallas, TX 75390-9035, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cerebrospinal Fluid Child Child, Preschool Female Fistula / radiography* Hearing Loss, Sensorineural / congenital, radiography Humans Infant Magnetic Resonance Imaging Male Oval Window, Ear / abnormalities*, radiography Semicircular Canals / abnormalities Tomography, X-Ray Computed |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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