Middle ear mucocele: An unusual complication of the tranlabyrinthine approach to acoustic neuroma

The complications of posterior fossa surgery continue to decrease in incidence as our collective experience broadens. Most complications are seen in the immediate postoperative period and are minimized by careful attentiveness to subtle changes in mental status, vital signs, and cranial nerve examination. Long-term follow-up is necessary to identify tumor recurrence, but strict imaging protocols as yet do not exist to facilitate the early identification of recurrent disease, as recurrence is very rare. We report the first case of secondary mucocele formation in the middle ear cleft following translabyrinthine excision of an intracanalicular acoustic neuroma. This complication was found in the fourth postoperative year on routine magnetic resonance imaging, which itself followed previously normal contrasted magnetic resonance imaging in the second postoperative year. The genesis of this complication and possible treatment options are discussed.