The University of Arizona
Department of Surgery

Temporal Bone Encephalocele

In general, encephaloceles are congenital (present at birth) and caused by failure of the neural tube to close completely in a developing fetus. This results in sac-like bulges of nerve tissue that come through gaps in the skull. Encephaloceles of the temporal bone are typically acquired rather than congenital and caused by head trauma, erosion of temporal bone by chronic suppurative otitis media/cholesteatoma, iatrogenic due to mastoid surgery or sometimes are idiopathic (form spontaneously).  Temporal bone encephaloceles may be asymptomatic for years but eventually produce conductive hearing loss, meningitis, cerebrospinal fluid (CSF) leaks, facial nerve weakness or (rarely) seizures.

Diagnosis of a temporal bone encephalocele is made after obtaining a thorough medical history, performing a microscope exam of the ears and evaluating temporal bone imaging (CT scans of the temporal bones or MRI scans with internal auditory canal protocol). Surgery is the only treatment option. Several surgical techniques including transmastoid and middle cranial fossa approaches are available to address these skull base defects, and the method recommended depends on the size and location of the encephalocele. The primary goal of surgery is to stop CSF leaks and prevent brain herniation, with preservation of hearing and middle ear function whenever possible.

Why Us? 
  • The University of Arizona’s Department of Surgery/Division of Otolaryngology has recruited top-tier, fellowship-trained faculty to Tucson, bringing subspecialty expertise to the Southwest.
  • UA Otolaryngology faculty members are experts in caring for common as well as complex ear, nose and throat diseases in children as well as adults.
  • Dr. Abraham Jacob, fellowship trained in Otology, Neurotology, and Cranial Base Surgery, is the first Neurotologist recruited to the Tucson area. He has specific expertise in transmastoid and middle cranial fossa approaches for repair of skull base defects causing formation of encephaloceles.
  • With the only university-based Otology/Neurotology program in the state of Arizona, Dr. Jacob’s active laboratory and clinical research program ensures that patients are offered only the most up-to-date treatment options.
  • The partnership between The University of Arizona, The University of Arizona Medical Center, and The University of Arizona Cancer Center brings together neurotologists, head and neck oncologic surgeons, radiation oncologists, medical oncologists, neurosurgeons, ICU physicians, neuroradiologists and tertiary care anesthesiologists under one roof – maximizing chances for success when treating complex problems of the skull base.

Patient Information