CASE REPORT   

Otorinolaringologia 2020 June;70(2):64-6

DOI: 10.23736/S0392-6621.20.02251-1

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Otitic hydrocephalus: revisiting an uncommon intracranial complication of a common disease

Kuganathan RAMASAMY ✉, Jeyasakthy SANIASIAYA, Norhaslinda ABDUL GANI

Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Tuanku Ja’afar, Seremban, Malaysia

Otitic hydrocephalus is an unusual complication of middle ear disease characterized by signs and symptoms of raised intracranial pressure without other focal neurological abnormalities. Its pathogenesis, albeit unclear, is often associated with occurrence of lateral sinus thrombosis. Herein, we present a case of otitic hydrocephalus in a 12-year-old boy following cortical mastoidectomy for left mastoiditis, who atypically presented with diplopia due to contralateral abducens nerve palsy. In our case, the traditional role of lumbar puncture as a diagnostic tool was omitted in favor of non-invasive and much sensitive radioimaging modality. Our case also highlights the role of anticoagulation in the treatment of otitic hydrocephalus, especially in post-operative propagation of thrombus. While intracranial complications following middle ear infection are rare since introduction of antibiotics, such sequelae still occur and require high index of suspicion by clinicians. Early recognition and treatment are essential for best clinical outcome.

KEY WORDS: Hydrocephalus; Ear, middle; Intracranial pressure; Complications; Lateral sinus thrombosis