In a patient with bilaterally operated otosclerosis, fatal meningitis originated from one ear. The left ear was operated in 1964. Fascial closure of the oval window was effective but the polytef (Teflon) tube had shifted from the optimal position. Infection from the right middle ear, operated upon in 1966, spread into the inner ear along the polyethylene strut which, owing to retraction of the drum, had been drawn slightly inside the vestibule. The pathway to the meninges was through the cochlear aqueduct. Both temporal bones showed large inactive and active otosclerotic foci extending through the cochlear capsule.
Palva T, Palva A, Kärjä J. Fatal Meningitis in a Case of Otosclerosis Operated Upon Bilaterally. Arch Otolaryngol. 1972;96(2):130–137. doi:10.1001/archotol.1972.00770090204007
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