Recurrent Meningitis Due to Congenital Petrous Fistula: A Case Report

A COMMUNICATION between the subarachnoid space and the middle ear cavity produces a serious and potentially lethal problem. The presence of a fistula in the petrous portion of the temporal bone may lead to otorrhea, pneumocephalus, meningitis, or abscess formation. It is obvious that diagnosis and surgical correction should be initiated promptly to prevent irreversible changes. Dandy1 has classified the causes of cerebrospinal fluid otorrhea into four groups: (1) temporal bone fracture, (2) openings created by operative procedures, (3) erosion by tumor or infection, and (4) congenital malformation. The diagnosis is not as difficult when one has a history of recent head trauma, surgery, or infection; however, recurrent meningitis unassociated with these factors presents a challenging diagnostic problem. The pediatrician, internist, or neurosurgeon will most likely see the patient first, and the otolaryngologist should be consulted if the patient has ear disease, otorrhea, rhinorrhea, a history of deafness, or recurrent