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Temporal Bone Cephalocele
Philip R. Chapman, MD; H. Ric Harnsberger, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Temporal lobe meningocele, encephalocele, or meningoencephalocele; defined by content
            • Definitions

              • Protrusion of cranial contents into middle ear (ME) or mastoid through dehiscence of tegmen ± CSF leak

            IMAGING

            • General Features

              • Imaging Recommendations

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Reporting Tips

                                        Selected References

                                        1. Hernandez-Montero E et al: Surgical management of middle cranial fossa bone defects: meningoencephalic herniation and cerebrospinal fluid leaks. Am J Otolaryngol. 41(4):102560, 2020
                                        2. Gupta A et al: Temporal bone meningoencephaloceles and cerebrospinal fluid leaks: experience in a tertiary care hospital. J Laryngol Otol. 133(3):192-200, 2019
                                        3. Grinblat G et al: Temporal bone meningo-encephalic-herniation: etiological categorization and surgical strategy. Otol Neurotol. 39(3):320-32, 2018
                                        4. Handzel O et al: Clinical implications of the association between temporal bone tegmen defects and superior semicircular canal dehiscence. Otol Neurotol. 39(6):797-802, 2018
                                        5. Jeevan DS et al: Cerebrospinal fluid leaks and encephaloceles of temporal bone origin: nuances to diagnosis and management. World Neurosurg. 83(4):560-6, 2015
                                        6. Alonso RC et al: Spontaneous skull base meningoencephaloceles and cerebrospinal fluid fistulas. Radiographics. 33(2):553-70, 2013
                                        7. Carlson ML et al: Temporal bone encephalocele and cerebrospinal fluid fistula repair utilizing the middle cranial fossa or combined mastoid-middle cranial fossa approach. J Neurosurg. 119(5):1314-22, 2013
                                        8. Goddard JC et al: Middle ear encephalocele: not just another chronic ear. Ear Nose Throat J. 91(2):E34, 2012
                                        9. Nadaraja GS et al: Radiographic evaluation of the tegmen in patients with superior semicircular canal dehiscence. Otol Neurotol. 33(7):1245-50, 2012
                                        10. Stucken EZ et al: The role of obesity in spontaneous temporal bone encephaloceles and CSF leak. Otol Neurotol. 33(8):1412-7, 2012
                                        11. Sanna M et al: Management of meningoencephalic herniation of the temporal bone: personal experience and literature review. Laryngoscope. 119(8):1579-85, 2009
                                        12. Johnson F et al: Temporal bone fracture: evaluation and management in the modern era. Otolaryngol Clin North Am. 41(3):597-618, x, 2008
                                        13. Nahas Z et al: Spontaneous meningoencephalocele of the temporal bone: clinical spectrum and presentation. Arch Otolaryngol Head Neck Surg. 134(5):509-18, 2008
                                        14. Jackson CG et al: Brain herniation into the middle ear and mastoid: concepts in diagnosis and surgical management. Am J Otol. 18(2):198-205; discussion 205-6, 1997
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Temporal lobe meningocele, encephalocele, or meningoencephalocele; defined by content
                                                  • Definitions

                                                    • Protrusion of cranial contents into middle ear (ME) or mastoid through dehiscence of tegmen ± CSF leak

                                                  IMAGING

                                                  • General Features

                                                    • Imaging Recommendations

                                                      • CT Findings

                                                        • MR Findings

                                                          • Nuclear Medicine Findings

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Hernandez-Montero E et al: Surgical management of middle cranial fossa bone defects: meningoencephalic herniation and cerebrospinal fluid leaks. Am J Otolaryngol. 41(4):102560, 2020
                                                                              2. Gupta A et al: Temporal bone meningoencephaloceles and cerebrospinal fluid leaks: experience in a tertiary care hospital. J Laryngol Otol. 133(3):192-200, 2019
                                                                              3. Grinblat G et al: Temporal bone meningo-encephalic-herniation: etiological categorization and surgical strategy. Otol Neurotol. 39(3):320-32, 2018
                                                                              4. Handzel O et al: Clinical implications of the association between temporal bone tegmen defects and superior semicircular canal dehiscence. Otol Neurotol. 39(6):797-802, 2018
                                                                              5. Jeevan DS et al: Cerebrospinal fluid leaks and encephaloceles of temporal bone origin: nuances to diagnosis and management. World Neurosurg. 83(4):560-6, 2015
                                                                              6. Alonso RC et al: Spontaneous skull base meningoencephaloceles and cerebrospinal fluid fistulas. Radiographics. 33(2):553-70, 2013
                                                                              7. Carlson ML et al: Temporal bone encephalocele and cerebrospinal fluid fistula repair utilizing the middle cranial fossa or combined mastoid-middle cranial fossa approach. J Neurosurg. 119(5):1314-22, 2013
                                                                              8. Goddard JC et al: Middle ear encephalocele: not just another chronic ear. Ear Nose Throat J. 91(2):E34, 2012
                                                                              9. Nadaraja GS et al: Radiographic evaluation of the tegmen in patients with superior semicircular canal dehiscence. Otol Neurotol. 33(7):1245-50, 2012
                                                                              10. Stucken EZ et al: The role of obesity in spontaneous temporal bone encephaloceles and CSF leak. Otol Neurotol. 33(8):1412-7, 2012
                                                                              11. Sanna M et al: Management of meningoencephalic herniation of the temporal bone: personal experience and literature review. Laryngoscope. 119(8):1579-85, 2009
                                                                              12. Johnson F et al: Temporal bone fracture: evaluation and management in the modern era. Otolaryngol Clin North Am. 41(3):597-618, x, 2008
                                                                              13. Nahas Z et al: Spontaneous meningoencephalocele of the temporal bone: clinical spectrum and presentation. Arch Otolaryngol Head Neck Surg. 134(5):509-18, 2008
                                                                              14. Jackson CG et al: Brain herniation into the middle ear and mastoid: concepts in diagnosis and surgical management. Am J Otol. 18(2):198-205; discussion 205-6, 1997