• Perilymphatic fistulae, developing even years after stapedectomy, open a communication between the perilymph and middle ear. These fistulae constitute a potential pathway for flora of the middle ear to invade the subarachnoid space by way of the cochlear aqueduct. Our patient developed pneumococcal meningitis 14 months after stapedectomy. The history of stapedectomy in a patient with meningitis is an indication for reexploration of the operative site. The appearance of fistula symptoms in patients who have had stapedectomy indicates a high risk for development of intracranial infection.
Snyder BD, Boies LR, Ulvestad RF, McGuiness PA. Delayed Meningitis Following Stapes Surgery. Arch Neurol. 1979;36(3):174–175. doi:10.1001/archneur.1979.00500390092013
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