Summary
A case report is presented in detail to illustrate how meningitis results from an inner ear anomaly, a developmental defect of the cochlea. On review of the literature isolated cases with similar congenital anomalies of the cochlea, a Mondini defect, have been found with recurrent bouts of meningitis. The cause for the meningitis was not localized.to the inner ear until multiple operations had been performed. All cases had a CSF leak through the oval window. Other cases have been reported with recurrent meningitis due to a CSF leak from various anomalies of the middle ear. Both middle and inner ear defects may present with either otorrhea or rhinorrhea and should be suspect in all cases with recurrent meningitis.
Résumé
Les auteurs présentent un cas de méningite résultant d'une anomalie de l'oreille interne, à savoir un développement défectueux de la cochlée. Une revue de la litérature montre des cas isolés avec de semblables anomalies congénitales de la cochlée, malformation de Mondini, avec méningite récidivante. Ce n'est qu'après de nombreuses interventions que la cause de la méningite a pu être localisée au niveau de l'oreille interne. Dans tous les cas, il existait un écoulement de liquide céphalorachidien à travers la fenêtre ovale. D'autres cas de méningite récidivente dus à un écoulement de liquide céphalo-rachidien à la suite de diverses anomalies de l'oreille moyenne, ont été rapportés. Tous les cas d'anomalie de l'oreille moyenne et de l'oreille interne avec othorhée ou rinhorhée peuvent être à l'origine de méningite récidivente.
Zusammenfassung
Fallbericht einer Meningitis, die nach einem Defekt an der Cochlea entstand. Bei der Literaturübersicht werden ähnliche Anlage-Anomalien der Cochlea (Mondini-Defekt) beschrieben, die wiederholt zu Meningitiden führten. In allen Fällen lag eine Liquorfistel durch das ovale Fenster vor. In anderen Fällen wurden wiederholt aufgetretene Meningitiden nach Liquorfistel im Bereich des Mittelohrs beobachtet.
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References
Barr, B., Wersall, J.: Cerebrospinal otorrhea with meningitis in congenital deafness. Arch. Otolaryng. 81, 26–28 (1965)
Bauer, E.: Spontaneous oto-liquorrhea based on a congenital malformation of the aqueductus cochleae. Z. Laryng. Rhinol. Otol. 41, 704–723 (1962)
Bennett, R. J.: On subarachnoid-tympanic fistulae. A report of two cases of the rare indirect type. J. Laryng. 80, 1242–1252 (1966)
Biggers, W. P., Howell, N. N., Fisher, N. D., et al.: Congenital ear anomalies associated with otic meningitis. Arch. Otolaryng. 97, 339–401 (1973)
Canfield, R. B.: Some conditions associated with the loss of cerebrospinal fluid. Ann. Otol. (St. Louis) 22, 604–622 (1913)
Crook, J. P.: Congenital fistula in the stapedial footplate. Sth. med. J. (Bgham. Ala.) 60, 1168–1170 (1967)
Dysart, B. R.: Spontaneous cerebrospinal otorrhea. Laryngoscope 69, 935–939 (1959)
Escat, E.: Écoulement spontané de liquide céphalorachidien par le conduit auditif externe; fistule congénitale probable. Arch. int. Laryng. (Paris) 10, 653–659 (1897)
Ferrer, J.: Cerebrospinal otorrhea. Ann. Otol. 69, 88–93 (1960)
Gundersen, T., haye, R.: Cerebrospinal otorrhea. Arch. Otolaryng. 91, 19–23 (1970)
Harrington, J. W. Jr., Birck, H. G.: Recurrent meningitis due to congenital petrous fistula. A case report. Arch. Otolaryng. 85, 572–575 (1967)
Jensen, J.: Malformations of the inner ear in deaf children. Acta Radiol. Supp. 286 (1969)
Kaufman, B., Jordan, V. M., Pratt, L. L.: Positive contrast demonstration of a cerebrospinal fluid fistula through the fundus of the internal auditory meatus. Acta Radiol. 9, 83–90 (1969)
Kaufman, H. H.: Nontraumatic cerebrospinal fluid rhinorrhea. Arch. Neurol. 21, 59–65 (1969)
Kline, O. R.: Spontaneous cerebrospinal otorrhea. Arch. Otolaryng. 18, 34–39 (1933)
Koch, H.: Meningocele of temporal bone. Acta oto-laryng. (Stockh.) 38, 59–61 (1950)
Kramer, S. A., Yanagisawa, E., Smith, H. L.: Spontaneous cerebrosinal fluid otorrhea simulating serous otitis media. Laryngoscope 81, 1083–1089 (1971)
Nenzelius, C.: On spontaneous cerebrospinal otorrhea due to congenital malformations. Acta oto-laryng. (Stockh.) 39, 341–328 (1951)
Pribram, H. F., Hass, A. C., Nishioka, H.: Radiographic localisation of a sponataneous cerebrospinal fluid fistula. Case report. J. Neurosurg. 24, 1031–1033 (1966)
Rice, W. J., Waggoner, J. G.: Congenital cerebrospinal fluid otorrhea via a defect in the stapes footplate. Laryngoscope 77, 341–349 (1967)
Rockett, F. X., Wittenborg, M. H., Shillito, J. Jr., et al.: Pantopaque visualization of a congenital dural defect of the internal auditory meatus causing rhinorrhea. Report of a case. Amer. J. Roentgenol 91, 640–646 (1964)
Schreyer, W., Sprenger, W.: Über basale cephalocelen. Z. Hals-, Nasen-u. Ohrenheilk. 17, 252–258 (1927)
Schuknecht, H. F., Seifi, A. E.: Experimental observations on the fluid physiology of the inner ear. Ann. Otol. 72, 687–712 (1963)
shalita, A. R.: Cerebrospinal fluid rhinorrhea in the etiology of recurrent pneumococcal meningitis. N.C. med. J. 25, 426–428 (1964)
Siebenmann, F.: Grundzüge der Anatomie und Pathogenese der Taubstummheit. Wiesbaden: 1904
skolnik, E. M., Ferrer, J. L.: Cerebrospinal otorrhea. Arch. Otolaryng. 70, 795–799 (1959)
Stool, S., Leeds, N. E., Shulman, K.: The syndrome of congenital deafness and otic meningitis: diagnosis and management. J. Pediat. 71, 547–552 (1967)
Tschiang, H. H., Harrison, M. S., Ozsahenaglu, C. A. N.: Cerebrospinal otorrhea. J. Laryng. 87, 475–483 (1973)
Updegraff, T. R.: Cerebrospinal fluid rhinorrhea: from a temporal bone defect. J. Iowa St. med. Soc. 48, 602–603 (1958)
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Carter, B.L., Wolpert, S.M. & Karmody, C.S. Recurrent meningitis associated with an anomaly of the inner ear. Neuroradiology 9, 55–61 (1975). https://doi.org/10.1007/BF00341421
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DOI: https://doi.org/10.1007/BF00341421