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Αλέξανδρος Γ. Σφακιανάκης

Sunday, April 18, 2021

Sensorineural Hearing Loss Caused by Labyrinthine Erosion Due to a Cerebrospinal Fluid Diverticulum

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Otol Neurotol. 2021 Apr 14. doi: 10.1097/MAO.0000000000003184. Online ahead of print.

ABSTRACT

OBJECTIVE: To present a case of progressive sensorineural hearing loss (SNHL) caused by labyrinthine erosion secondary to expanding geniculate ganglion cerebrospinal fluid (CSF) diverticulum extending along the path of the facial nerve.

PATIENT: Thirteen-year-old man with no past medical history or risk factors presented with unilateral progressive SNHL and no other otologic or neurologic symptoms.

INTERVENTIONS: Audiological data as well as imaging studies including a magnetic resonance imaging (MRI) of the brain and internal auditory canal and a temporal bone computed tomography (CT) are presented. Partial labyrinthectomy, CSF leak closure, and cochlear implantation were performed. A lumbar puncture was obtained 2 months postoperatively.

MAIN OUTCOME MEASURE: Closure of the CSF leak.

RESULTS: Mastoidectomy revealed a wide a rea of CSF leak through the geniculate ganglion and fallopian canal with partial destruction of the superior and lateral semicircular canals by an expanding diverticulum.

CONCLUSIONS: This is an unusual presentation of progressive SNHL due to partial labyrinthine erosion due to a meningocele of the geniculate ganglion along the fallopian canal. It is likely that the patient had a congenital open pathway through the labyrinthine segment of the facial nerve and CSF pulsations created the meningocele over a few years. This case argues for early closure of such CSF diverticula to prevent possible SNHL due to labyrinthine erosion.

PMID:33859132 | DOI:10.1097/MAO.0000000000003184

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