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Summary Introduction Spontaneous meningocele or meningoencephalocele of the temporal bone are very rare. Mostly they are result from otologic surgery or head trauma. Spontaneous meningoencephalocele may occur mostly in the epitympanum or mastoid antrum. It could be a result of pathologic obesity. Often it could be misdiagnosed because of less symptomatic. The most expected symptoms could be: unilateral conductive hearing loss with middle ear effusion, pulsatile tinnitus or CSF leak. Material and methods We present a case of 61 year old, obese woman with spontaneous meningoencephalocele of the left temporal bone. The patient presented symptoms of conductive hearing loss with fullness in the left ear and pulsatile tinnitus. The imagine study such as CT scan and MRI showed a dehiscent areas in the tegmen at the right side and meningoencephalocele protruding into the left mastoid cavity on the left side. Results After complete diagnosis we preformed surgery. A mastoidectomy of the left temporal bone was done and the meningoencephalocele tissue was encountered. The bony defect and CSF leak was closure. The patient was released from pulsatile tinnitus and fullness in the ear, but a component of hearing dysfunction is still present. Conclusions Spontaneous meningoencephalocele of the temporal bone may occur in an obese patient. The most finding will be a middle ear effusion and conductive hearing loss with pulsatile tinnitus. The combination of CT and MRI will help in proper preoperative diagnosis. The operation include transmastoid, middle cranial fossa repair or combination of both. The multi layer closure of bony defect is very important to avid CSF leak.

arterial hypertension, myocardial infarction, lupus Our study group consisted of 37 patients, all men erythematosus, and rheumatoid arthritis and are aged 42 to 76 years (mean 54 years), with histopathusually explained as an acute phase reactant or ologically recognised planoepithelial carcinoma of marker of endothelial injury [3–9]. In neoplastic larynx. The stadium of carcinoma was evaluated diseases both increased and decreased levels of as T, N, M, and stages (Table 1). The control group von Willebrand factor are reported. Usually in the consisted of 48 healthy men, aged 28–63 years course of neoplastic disease a tendency to reach (mean 46 years). The patients were categorised increased plasma levels of vWf:Ag is observed [10– into groups according to tumor size (T3–T4), metas13]. Sometimes decreased levels associated with tasis to lymph nodes (N2–N2), and stages III–IV. acquired von Willebrand Disease were recorded We did not observe patients with remote metastasis for Wilms’ tumor and adrenocortical adenocarciso they should all be classified as M. Blood samples noma [14,15]. Recent studies suggest that increased of patients were drawn before operation from cubilevels of vWf:Ag correlate with progression of distal vein after minimal stasis. Blood was collected ease, metastasis, or survival time and thus may into 125 nM sodium citrate in ratio 1:9 volume have a prognostic significance [10,11,13]. blood. After centrifugation at 3000g for 10 minutes Studying the literature we found only one report the plasma was frozen in polystyrene tubes and referring vWf:Ag concentrations in larynx cancer. stored at 2408C. The levels of vWf:Ag were meaPublished results included among other types of sured by enzyme linked immunosorbent assay head and neck cancer a group of 10 patients with (ELISA) using commercial antisera (Dako, Glos