Encephalocele of the Temporal Bone
In general, encephaloceles are congenital (present at birth) and caused by failure of the neural tube to close completely in a developing fetus. This results in sac-like bulges of brain tissue that come through gaps in the skull. Encephaloceles of the temporal bone are typically acquired rather than congenital and caused by head trauma, erosion of temporal bone by chronic suppurative otitis media/cholesteatoma, iatrogenic due to mastoid surgery or sometimes are idiopathic (form spontaneously). Temporal bone encephaloceles may be asymptomatic for years but eventually produce conductive hearing loss, meningitis, cerebrospinal fluid (CSF) leaks, facial nerve weakness or (rarely) seizures.
Diagnosis of a temporal bone encephalocele is made after obtaining a thorough medical history, performing a microscope exam of the ears and evaluating temporal bone imaging (CT scans of the temporal bones or MRI scans with internal auditory canal protocol). Surgery is the only treatment option. Several surgical techniques including transmastoid and middle cranial fossa approaches are available to address these skull base defects, and the method recommended depends on the size and location of the encephalocele. The primary goal of surgery is to stop CSF leaks and prevent brain herniation, with preservation of hearing and middle ear function whenever possible.
Why Choose Us
- Dr. Abraham Jacob, Medical Director for Ear & Hearing (E&H) at the Center for Neurosciences (CNS), is fellowship trained in Otology, Neurotology, and Cranial Base Surgery. He is the first and most experienced Neurotologist recruited to Southern Arizona.
- Dr. Jacob was a founding member of the University of Arizona (UA) Department of Otolaryngology prior to his departure and transition to CNS. At UA, he was Vice Chair of ENT and held the rank of full Professor with Tenure.
- Dr. Jacob transitioned his practice to the Center for Neurosciences in early 2017 as he felt that the new environment helped to optimize delivery of personalized ear and lateral skull base care.
- The partnership between Center for Neurosciences and Tucson Medical Center brings together neurotologists, head and neck surgeons, radiation oncologists, medical oncologists, neurosurgeons, ICU physicians, neuro-radiologists and tertiary care anesthesiologists under one roof – maximizing chances for success when treating complex problems of the skull base.