Otitic Hydrocephalus: Case Report on a Rare Complication of Chronic Otitis Media with Emphasis on Management

Otitic hydrocephalus is a rare complication of chronic otitis media (COM) and presents as a form of benign intracranial hypertension with dural venous sinus thrombosis. It presents with features of raised intracranial pressure in the absence of intracranial space-occupying lesions. Cerebrospinal flu...

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Bibliographic Details
Published in:Indian journal of otology 2024-07, Vol.30 (3), p.220-223
Main Authors: Chakravarty, Sharmistha, Rana, Sohel, Gandhoke, Charandeep Singh
Format: Article
Language:English
Subjects:
Abscesses
Blood clot
Ear diseases
Hydrocephalus
Intracranial hypertension
Intracranial pressure
Otitis media
Thrombosis
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Summary:Otitic hydrocephalus is a rare complication of chronic otitis media (COM) and presents as a form of benign intracranial hypertension with dural venous sinus thrombosis. It presents with features of raised intracranial pressure in the absence of intracranial space-occupying lesions. Cerebrospinal fluid (CSF) shows normal cytology and biochemical picture. We present a rare case of otitic hydrocephalus in a young male who presented with an 8-year history of left ear discharge and a 2-week history of drowsiness, lethargy, progressively worsening headache, fever, blurring of vision, and imbalance. His cerebellar signs were positive, and the fundus examination detected papilledema. Imaging revealed left-sided cerebellar abscess with mastoiditis, compression of the left ventricle, and lateral and superior sagittal sinus thrombosis. Lumbar puncture showed raised CSF opening pressure. The diagnosis of COM squamosal with cerebellar abscess and otitic hydrocephalus was made. Urgent ventriculoperitoneal shunt was placed, followed by cerebellar abscess drainage and mastoid exploration. Modified radical mastoidectomy of the left ear was done with cartilage ossiculoplasty to preserve residual hearing in the patient. High index of suspicion is required in otitic hydrocephalus, where ear symptoms are masked by raised intracranial pressure symptoms. The placement of shunt to tackle raised CSF pressure preceded surgical intervention. Modified radical mastoidectomy with ossiculoplasty was performed to preserve residual hearing in this case. Prompt intervention by multidisciplinary team can reduce morbidity in these patients.
ISSN:0971-7749
2249-9520
DOI:10.4103/indianjotol.indianjotol_95_24