{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T09:57:39Z","timestamp":1784282259313,"version":"3.55.0"},"reference-count":16,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2008,3,17]],"date-time":"2008-03-17T00:00:00Z","timestamp":1205712000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2008,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Meningo-encephalocoele of the temporal bone, also known as fungus cerebri, is a rare occurrence in clinical practice. We present a series of 13 patients with chronic otitis media who suffered brain herniation into the mastoid cavity. We also discuss the presentation and management of brain herniation with or without cerebrospinal fluid leak.<\/jats:p><jats:sec id=\"S0022215108001990_sec1\"><jats:title>Study design:<\/jats:title><jats:p>Retrospective.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215108001990_sec2\"><jats:title>Methods:<\/jats:title><jats:p>Among 963 cases undergoing revision mastoid surgery, 13 patients suffered brain herniation. These cases were identified and analysed.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215108001990_sec3\"><jats:title>Results:<\/jats:title><jats:p>All 13 patients' initial diagnosis was chronic suppurative otitis media with cholesteatoma, and all had undergone previous mastoid surgery resulting in a defect in the tegmen and weakening of the dura mater. The revision procedures performed included 10 (76.9 per cent) modified radical mastoidectomies without ossicular chain reconstruction and one (7.6 per cent) modified radical mastoidectomy with ossicular chain reconstruction; two (15.3 per cent) patients required a blind sac closure. Brain herniation and\/or cerebrospinal fluid leak were repaired by a transmastoid\u00a0\u00b1\u00a0minicraniotomy procedure.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215108001990_sec4\"><jats:title>Conclusions:<\/jats:title><jats:p>Injury to the tegmen and dura should be avoided during surgery for chronic middle-ear disease. Cerebrospinal fluid leaks, if encountered, should be managed in the same surgical session. The transmastoid approach is helpful in repairing defects smaller than 1\u00a0cm in diameter, whereas the combined transmastoid-minicraniotomy approach provides good access when closing defects larger than 1\u00a0cm in diameter and also enables auto-calvarial grafting.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215108001990","type":"journal-article","created":{"date-parts":[[2008,3,17]],"date-time":"2008-03-17T12:54:40Z","timestamp":1205758480000},"page":"1168-1174","source":"Crossref","is-referenced-by-count":16,"title":["Management of temporal bone meningo-encephalocoele"],"prefix":"10.1017","volume":"122","author":[{"given":"K K","family":"Ramalingam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Ramalingam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T M","family":"SreenivasaMurthy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G R","family":"Chandrakala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2008,3,17]]},"reference":[{"key":"S0022215108001990_ref9","first-page":"390","article-title":"Idiopathic temporal encephalocele: report of two cases","volume":"20","author":"Vallicioni","year":"1999","journal-title":"Am J Otol"},{"key":"S0022215108001990_ref13","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2880130110"},{"key":"S0022215108001990_ref6","doi-asserted-by":"publisher","DOI":"10.1053\/ajot.2002.123456"},{"key":"S0022215108001990_ref1","first-page":"198","article-title":"Brain herniation into the middle ear and mastoid: concepts in diagnosis and surgical management","volume":"18","author":"Jackson","year":"1997","journal-title":"Am J Otol"},{"key":"S0022215108001990_ref7","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.34.3.363"},{"key":"S0022215108001990_ref10","first-page":"74","article-title":"Magnetic resonance imaging of brain herniation into the middle ear","volume":"13","author":"Kaseff","year":"1992","journal-title":"Am J Otol"},{"key":"S0022215108001990_ref14","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198308000-00012"},{"key":"S0022215108001990_ref8","article-title":"Spontaneous cerebrospinal fluid leakage and middle ear encephalocele in seven patients","author":"Patel","year":"2008","journal-title":"Ear, Nose Throat J"},{"key":"S0022215108001990_ref11","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100114550"},{"key":"S0022215108001990_ref2","first-page":"40","article-title":"Temporal lobe encephalocoele presenting with seizures and hearing loss","volume":"45","author":"Yang","year":"2004","journal-title":"Singapore Med J"},{"key":"S0022215108001990_ref15","first-page":"765","article-title":"Spontaneous cerebrospinal fluid otorrhea from defects of temporal bone: a rare entity?","volume":"16","author":"May","year":"1995","journal-title":"Am J Otol"},{"key":"S0022215108001990_ref12","first-page":"403","article-title":"Dural bone defects and encephalocele associated with chronic otitis media or its surgery [in Turkish]","volume":"9","author":"Kizilay","year":"2002","journal-title":"Kulak Burun Bogaz Ihtis Derg"},{"key":"S0022215108001990_ref3","doi-asserted-by":"publisher","DOI":"10.1177\/000348941001900302"},{"key":"S0022215108001990_ref4","first-page":"512","article-title":"Meningoencephalic herniation into the middle ear: a report of 27 cases","volume":"105","author":"Aristequi","year":"1995","journal-title":"Laryngoscope"},{"key":"S0022215108001990_ref5","first-page":"461","article-title":"Temporal bone encephalocele and cerebrospinal fluid leaks","volume":"17","author":"Lundy","year":"1996","journal-title":"Am J Otol"},{"key":"S0022215108001990_ref16","doi-asserted-by":"publisher","DOI":"10.1177\/000348949910800706"}],"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215108001990","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T22:06:06Z","timestamp":1556661966000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215108001990\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,3,17]]},"references-count":16,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2008,11]]}},"alternative-id":["S0022215108001990"],"URL":"https:\/\/doi.org\/10.1017\/s0022215108001990","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,3,17]]}}}