[Spontaneous middle ear meningoencephalic herniation. 2 case reports]

[Combined approach for the treatment of spontaneous temporal encephaloceles: transmastoid plus temporal minicraniotomy]

Spontaneous encephaloceles are defined as brain herniations with no apparent cause. The aim of this paper is to describe the surgical technique performed in our department. We reviewed the last 3 cases treated with combined approach (transmastoid plus minicraniotomy) with 2-layer closure. In all cases the bone defects were located and successfully sealed. We had no postoperative complications. There were no relapses in our follow-up period. The transmastoid approach has the advantage over the open approach with middle fossa craniotomy in that it locates the bone defect with no brain retraction. Nevertheless, it is not useful in large-sized, multiple or anterior defects. Due to those drawbacks, we think that the combined approach with temporal minicraniotomy is the best choice for this entity.

[Atypical etiology of rhinorrhea: spontaneous bilateral temporal encephalocele]

Spontaneous herniation of brain parenchyma through a dural and osseous defect in the temporal bone is a rare entity and a bilateral form is even more infrequent. It usually presents as an intermittent but persistent otorrhea. Manifestation as nose cerebrospinal fluid (CSF) leak is very uncommon. Our objective is presenting this unusual case report of a spontaneous bilateral encephalocele with a bilateral tegmen tympani defect.