Thursday 9 February 2012

Tegmen Plate

A 35 y o pt with recurrent meningitis. Now complaints of right side headache.
HRCT of Temporal bone coronal reconstruction images show:
Opacification of normally pneumatised right side mastoid and middle ear suggestive of Acute Mastoiditis and Otitis media. Tegmen tympani is intact. Marked thinning and destruction of Tegmen mastoideum appears to be the reason for recurrent meningitis.

Tegmen is a plate of bone of variable thickness when forms roof of Epitympanum called Tegmen Tympani and when forms roof of mastoid called Tegmen Mastoideum, form crucial barrier preventing spread of middle or mastoid infection to intracranially.

MRI Brain reveled no significant signal abnormality and MR Venogram was normal, important in such cases to rule out adjacent parenchymal involvement and sigmoid sinus thrombosis. 

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