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ISSN 1025-0255 (Electronic)

2016, Number 1

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AMC 2016; 20 (1)

Fistula of the middle ear: a case report

Santana ÁJ, Quesada RG, León MM, Miranda RMÁ, Montejo MJ, del Barrio TI

Language: Spanish
References: 18
Page: 69-76
PDF size: 382.03 Kb.


ABSTRACT

Background: fistulas of cephalospinal liquid in the ear have many causes. Translabyrinthine fistulae are associated with congenital causes in the 95% of the patients. Spontaneous otorrhea fistulae are consequence of a dural defect that causes an abnormal communication between the subarachnoid space and pneumatized cavities of the temporal bone. This abnormal communication is the access of pathogenic germs and can cause an infection in the central nervous system. This serious complication can compromise the life of the patient. The risk ofm eningitis in patients with fistulae of the cephalospinal liquid is about a 50%.
Objective: to describe the case of a female patient with a congenital fistula and repeated manifestations of meningoencephalitis.
Clinical case: a nine-year-old female patient with a congenital fistula who had presented manifestations of meningoencephalitis 25 times. The surgery was conducted using autologous tissue placed in multiple layers linked with Tisuacryl®. A vestibular closure of the fistula was performed preventing the recurrence of meningoencephalitis. The patient had a favorable progress after the operation.
Conclusion: the early diagnosis through a correct physical examination, the confirmation of the nature of the liquid by the laboratory, the imaging test that confirmed the clinical suspicion, and the combined closure of the fistula with autologous tissue constituted the right diagnostic-therapeutic sequence that guaranteed the success in this patient.


REFERENCES

  1. Paula Vernetta C De, Ramírez Sabio JB, García Callejo J, Serrano Carañana MN Marco Algarra J. Fístulas de líquido cefalo-rraquídeo en oído: a propósito de 5 casos. Acta Otorrinolaringol Esp. 2005;56:273-9.

  2. Vignaud J, Marsot-dupuch K, Pharaboz C, Derosier C, Cordoliani Y. Imaging of the vestibule. Otolaryngol head neck surg. 1995;12:36-49.

  3. Nakashimaa T, Sonea M, Teranishia M, TominagaaM, Sugiuraa M, Naganawa S. Imaging of Congenital perilymphatic fistula. Int J Pediatr Otorhinolaryngol. 2003;67:421-5.

  4. Vargas Díaz J, Garófalo Gómez N, Rodrí-guez U, Parra M, Barroso García E, Novoa López L, et al. Displasia de Mondini: menin-gitis bacteriana recurrente en la adolescen-cia. Rev Neurol. 2004;39(10):935-9.

  5. Rao AK, Merenda DM, Wetmore SJ. Diagno-sis and management of spontaneous cere-brospinal fluid otorrhea. Otology and Neu-rotology. 2005;26:1171-5.

  6. Foyt D, Brackmann DE. Cerebrospinal fluid otorrhea through a congenitally patent fal-lopian canal. Arch Otolaryngol Head Neck Surg. 2000;126(4):540-2.

  7. Rupa V, Agarwal I, Rajshekhar V. Congeni-tal perilymph fistula causing recurrent men-ingitis: lessons learnt from a single-institution case series. Otolaryngol Head Neck Surg. 2014 Feb;150(2):285-91.

  8. Savva A, Taylor MJ, Beatty CW. Manage-ment of cerebrospinal fluid leaks involving temporal bone: report on 92 patients. The Laryngoscope. 2003;113:50-6.

  9. Galbarriatu J, Aurrecoechea E, Ruiz de Gopegui I, Pomposo G, Bilbao S, González I, et al. Otolicuorrea espontánea en el adul-to. Presentación de dos casos y revisión de la Literatura. Neurocirugía. 2011;22:150-6.

  10. Wang HS, Kuo MF, Huang SC. Diagnostic approach to recurrent bacterial meningitis in children. Chang Gung Med J. 2005 Jul;28(7):441-52.

  11. Soult Rubio A, Rangel Pineda C, Muñoz Sáez M, Parrilla Parrilla JS, Díaz Fernández F, López Castilla JD, et al. Meningitis neu-mocócica: características epidemiológicas, clínicas y bacteriológicas. An Esp Pediatr. Oct 2001;55(4):315–20.

  12. Galbarriatu L, Aurrecoechea J, Ruiz de Gopegui E, Pomposo I, Bilbao G, González S, et al. Otolicuorrea espontánea en el adulto: Presentación de dos casos y revi-sión de la literatura. Neurociru-gía [Internet]. Abr 2011 [citado 20 May 2015];22(2):[aprox. 6 p.]. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-14732011000200006&lng=es

  13. Kuhweide R, Casselman JW. Spontaneous cerebrospinal fluid otorrhea from a tegmen defect: transmastoid repair with minicrani-otomy. Ann Otol Rhinol Laryngol. 1999;108:653-8.

  14. Kwartler JA, Schulder M, Baredes S, Chan-drasekhar SS. Endoscopic closure of the eustachian tube for repair of cerebrospinal fluid leak. Am J Otol. 1996;17(3):470-2.

  15. Urata S, Kashio A, Sakamoto T, Kakigi A, Yamasoba T. Novel repair of stapedial foot-plate defect associated with recurrent men-ingitis. Otol Neurotol. 2014 Oct;35(9):1592-5.

  16. Markou K, Rachovitsas D, Veros K, Tsirop-oulos G, Tsalighopoulos M, Psillas G. Peri-lymphatic fistula of the round window after whiplash injury: another cause of inner ear conductive hearing loss. Am J Otolaryngol. 2014 Nov-Dec;35(6):822-5.

  17. Yamauchi D, Yamazaki M, Ohta J, Ka-dowaki S, Nomura K, Hidaka H, et al. Closure technique for labyrinthine fistula by "underwater" endoscopic ear surgery. Laryngoscope. 2014 Nov;124(11):2616-8.

  18. Magliulo G, Iannella G, Ciniglio Appiani M, Re M. Subtotal petrosectomy and cerebro-spinal fluid leakage in unilateral anacusis. J Neurol Surg B Skull Base. 2014 Dec;75(6):391-6.




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