Hình 8,13 phần xương ngang thời gian này từ một người đàn ông lớn tuổi đã chết vì viêm màng não thứ phát viêm tai giữa cấp tính phế cầu khuẩn. Đầu mũi tên chỉ hạt màng nhện chịu trách nhiệm cho các phần mở rộng của nhiễm trùng vào hố sau (PF). Một vùng hang vị mastoid, kênh hình bán nguyệt sau | 74 Chapter 8 Spontaneous Cerebral Spinal Fluid Otorrhea Fig. This horizontal temporal bone section from an elderly man who died from meningitis secondary to acute pneumococcal otitis media. Arrowhead points to arachnoid granulation responsible for the extension of infection into the posterior fossa PF . A mastoid antrum P posterior semicircular canal 8 COMPLICATIONS TO AVOID 1. Secure an early diagnosis of CSF dural defect with CT and MRI to avoid delay in diagnosis. 2. The middle cranial fossa approach to the repair of dural defects in the tegmen is best to avoid damage to the sound transmission system. 3. Dural defects should be repaired as soon as diagnosis made to prevent intracranial complications. Z Pearl Arachnoid granulations in the temporal bone should be considered in the differential diagnosis of refractory unilateral serous otitis media in an adult. References 1. Adams GL McCoid G Weisbeski D 1982 Cerebrospinal fluid otorrhea presenting as serous otitis media. Minn Med 65 410-415 2. Anderson J Backer V Jensen E Voldsgaard P Wandall JH 1995 Acute meningitis of unknown aetiology analysis of 219 cases admitted to hospital between 1977 and 1990. J Infect 31 115-122 3. Ahren C Thulin CA 1965 Lethal intracranial complications following inflation in treatment of serous otitis media and due to defects in the petrous bone. Acta Otolaryngol Stockh 60 407-421 4. Brunner H 1946 Intracranial complications of ear nose and throat infections. Year Book Chicago pp 32-33 5. Bruyn GA Kremer HP deMarie S Padberg GW Hermans J Van Furth R 1989 Clinical evaluation of pneumococcal meningitis in adults over a twelve year period. Eur J Clin Microbial Infect Dis 8 695-700 6. D Avella D Baroni A Mingrino S Scanarini M 1980 An electron microscope study of human arachnoid villi. Surg Neurol 14 41-47 7. Dysart BR 1959 Spontaneous cerebrospinal otorrhea. Laryngoscope 69 935-939 8. Elverland HH Mair IWS 1983 Recurrent meningitis congenital anacusis and Mondini anomaly. Acta .
