Fungus cerebri (brain fungus): a rare complication of mastoidectomy

Abstract

Fungus cerebri is a relatively rare disease. The various reasons attributed to such pathology are, long standing mastoiditis, previous temporal lobe fracture, spontaneous herniation and most important common cause is post operative to mastoidectomy. The diagnosis is mainly clinical and supplemented by imaging studies. The commonly herniated part is the temporal lobe, but cerebellar herniation are also reported Different surgical modalities are used in managing this condition. Surgical approaches in the treatment of brain herniation into the mastoid or middle ear are, neurosurgical, otosurgical and combined. A case of fungus cerebri complicating mastoidectomy is presented and the pathogenesis is discussed.

Keywords: Brain fungus; Fungus cerebri; Masoidectomy.

Fig. 1

a CT scan coronalsection showing brain herniation through tegmen tympani (right side). b CT scan axial section showing brain herniation through tegmen tympani (right side)

Fig. 2

Mass filling EAC (right side)

Fig. 3

Cholesteatoma medial to herniated brain in mastoid cavity and middle ear (right side)

Fig. 4

Brain fungus in EAC, through defect in tegmen tympani (right side)

Fig. 5

Herniated brain tissue after removal with bipolar cautery (right side)

Fig. 6

a Site for auto calvarial graft. b Tegmen tympani defect sealed with temporalis fascia and auto calvarial graft (right side)