J Neurol Surg B Skull Base 2016; 77 - LFP-13-06
DOI: 10.1055/s-0036-1592623

The Surgical Management of Temporal Bone and Lateral Skull Base Defects

Hannah J. D. North 1, Simon R. M. Freeman 1, Scott A. Rutherford 1, Andrew T. King 1, Chorlatte L. Hammerbeck-Ward 1, Jawad Yousaf 1, Simon K. Lloyd 1
  • 1Manchester Skull Base Centre, Salford Royal Foundation Trust, Salford, United Kingdom

Object: Defects in the lateral skull base through the tegmen tympani or tegmen mastoideum allow communication of the sterile CSF environment with the middle ear. Risk of CSF leak presenting with otorrhea or rhinorrhea, the development of meningitis or further cranial infections are the main reason for surgical closure of these defects. We present our series of lateral skull base defects and discuss their presentation, surgical management and outcomes.

Methods: Patients from the database for the Manchester Skull Base Unit Multidisciplinary Meeting were analyzed from 2012 to 2015. All patients presenting with temporal bone or lateral skull base meningocele, meningoencephalocele, encephalocele and CSF leak were included.

Results: We include discussion of 53 patients of which 39 females (74%), average age 53 years at presentation. Ten patients had associated cholesteatoma disease. One patient presented with temporal lobe abscess. Three patients presented with cerebrospinal fluid (CSF) otorrhea. Surgical approach was transmastoid approach or combined with middle cranial fossa craniotomy.

Conclusion: We will discuss the varying methods used to close the bony defect and their success rates.