Challenges in the Management of Symptomatic Fallopian Canal Meningoceles: A Multicenter Case Series and Literature Review
Date
2024-04
Journal Title
Journal ISSN
Volume Title
Repository Usage Stats
views
downloads
Citation Stats
Abstract
<jats:sec> <jats:title>Objective</jats:title> <jats:p>To describe the presentations, the diagnosis, our treatment approaches, and the outcomes for 11 patients with fallopian canal meningocele (FCM).</jats:p> </jats:sec> <jats:sec> <jats:title>Study Design: Multicenter</jats:title> <jats:p>Retrospective case series.</jats:p> </jats:sec> <jats:sec> <jats:title>Setting</jats:title> <jats:p>Tertiary referral centers.</jats:p> </jats:sec> <jats:sec> <jats:title>Patients</jats:title> <jats:p>Patients (N = 11) with radiographically or intraoperatively identified, symptomatic FCM.</jats:p> </jats:sec> <jats:sec> <jats:title>Interventions</jats:title> <jats:p>Surgical repair of cerebrospinal fluid (CSF) leak and meningocele versus observation.</jats:p> </jats:sec> <jats:sec> <jats:title>Main Outcome Measures</jats:title> <jats:p>Presentation (including symptoms, radiographic imaging, and comorbidities), management (including surgical approach, technique for packing, use of lumbar drain), clinical outcomes (control of CSF leak, meningitis, facial nerve function), and revision surgery.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Patients presented with spontaneous CSF leak (n = 7), conductive (N = 11) and sensorineural hearing loss (n = 3), nonpositional intermittent vertigo (n = 3), headaches (n = 4), and recurrent meningitis (n = 1). Risk factors in our series included obesity (n = 4), Chiari 1 malformation (n = 1), and head trauma (n = 2). Noncontrast computed tomography of the temporal bone and magnetic resonance imaging were positive for FCM in 10 patients. Eight patients were managed surgically via a transmastoid approach (n = 4), combined transmastoid and middle fossa (N = 3), or middle fossa alone (n = 1); three were managed conservatively with observation. Postoperative complications included worsened facial nerve palsy (n = 1), recurrent meningitis (n = 1), and persistent CSF leak that necessitated revision (n = 1).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Facial nerve meningoceles are rare with variable presentation, often including CSF otorrhea. Management can be challenging and guided by symptomatology and comorbidities. Risk factors for FCM include obesity and head trauma, and Chiari 1 malformation may present with nonspecific otologic symptoms, in some cases, meningitis and facial palsy. Layered surgical repair leads to high rates of success; however, this may be complicated by worsening facial palsy.</jats:p> </jats:sec>
Type
Department
Description
Provenance
Subjects
Citation
Permalink
Published Version (Please cite this version)
Publication Info
Filip, Peter, Harry Chiang, Allison Goldberg, Azita S Khorsandi, Gul Moonis, Stephanie A Moody Antonio, George Wanna, Maura Cosetti, et al. (2024). Challenges in the Management of Symptomatic Fallopian Canal Meningoceles: A Multicenter Case Series and Literature Review. Otology & Neurotology, 45(4). pp. 434–439. 10.1097/mao.0000000000004155 Retrieved from https://hdl.handle.net/10161/30365.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
Collections
Scholars@Duke

Harry Chiang
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.