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J Neurol Surg B Skull Base 2014; 75(04): 279-287
DOI: 10.1055/s-0034-1371524
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Combined Approach for Tegmen Defects Repair in Patients with Cerebrospinal Fluid Otorrhea or Herniations: Our Experience

Daniele Marchioni
1   Department of Otolaryngology—Head and Neck Surgery, University Hospital of Modena, Modena, Italy
,
Marco Bonali
1   Department of Otolaryngology—Head and Neck Surgery, University Hospital of Modena, Modena, Italy
,
Matteo Alicandri-Ciufelli
1   Department of Otolaryngology—Head and Neck Surgery, University Hospital of Modena, Modena, Italy
,
Alessia Rubini
1   Department of Otolaryngology—Head and Neck Surgery, University Hospital of Modena, Modena, Italy
,
Giacomo Pavesi
2   Department of Neurosurgery, New Civil Hospital Sant'Agostino-Estense, Baggiovara (MO), Italy
,
Livio Presutti
1   Department of Otolaryngology—Head and Neck Surgery, University Hospital of Modena, Modena, Italy
› Author Affiliations
Further Information

Publication History

27 December 2013

13 January 2014

Publication Date:
02 May 2014 (online)

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Abstract

Objectives To describe our departmental experience in the surgical repair of tegmen tympani defects using a combined transmastoid/minicraniotomic approach.

Design Retrospective review of videos from surgery and patients' charts.

Setting Tertiary university referral center.

Participants Twenty-two patients who underwent surgical repair of tegmen defects associated with cerebrospinal fluid (CSF) leakage and/or meningocele/meningoencephalocele by a combined transmastoid/minicraniotomic approach.

Main Outcome Measures A retrospective review of videos of surgery and charts of patients with tegmen tympani or tegmen antri defects and CSF leakage, temporal lobe encephalocele, and/or meningoencephalocele.

Results All patients underwent the combined approach and had their defects closed, without significant intraoperative or postoperative complications.

Conclusions Mastoidectomy with temporal minicraniotomy represents an effective approach in patients with tegmen tympani dehiscence; the advantages of this technique are the control of the floor of the middle cranial fossa and the possibility to reach bony defects located anteriorly without manipulation of the ossicular chain and temporal lobe.

Keywords

tegmen tympani - middle cranial fossa approach - meningocele - encephalocele - cerebrospinal fluid leakage
 

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