Morbid complications of otitic hydrocephalus.

PURPOSE: To report two cases of otitic hydrocephalus with long-term complications. DESIGN: Retrospective case reports. PARTICIPANTS: Two patients with otitic hydrocephalus with previously diagnosed otitis media. METHODS: Review of clinical history, radiographic findings, medical and surgical management, and follow-up. RESULTS: Two patients with previously diagnosed otitis media presented with otitic hydrocephalus. Both were found to have elevated opening pressures with lumbar puncture and radiographic evidence of sinus thrombosis. Although the patients received appropriate medical and surgical management, they both suffered long-term complications. Patient 1 is dependent on a ventriculoperitoneal shunt to control headaches and has required multiple shunt revisions. Patient 2 is dependent on a ventriculoperitoneal shunt to control headaches and has permanent decreased visual acuity and bilateral optic neuropathy. During her clinical course, she required an optic nerve sheath fenestration. CONCLUSIONS: Otitic hydrocephalus can result in permanent vision loss and chronic headaches requiring spinal fluid diversion. We report two cases with morbid complications. A collaborative effort from ophthalmologists, otolaryngologists, and neurosurgeons is recommended to achieve the best clinical outcome.