[Management of breach of the tegmen isolated or associated with cephalocele].
This is a retrospective report of 41 tegmen breaches observed in 2 different populations : 27 patients among a series of 252 cases of operated chronic otitis (6.7%) and 14 patients admitted for management of tegmen breach and dura mater involvement. The most frequent cause was chronic otitis (36 cases, including 6 due to iatrogenic causes); there were also 2 cases of petrus fracture, 2 cases of intracranial hypertension and 1 idiopathic case. Computed tomography revealed a bony breach in 97% of the cases. Encephalo-meningocele was associated in 11 cases (31%). In these cases, MRI confirmed the preoperative diagnosis. Treatment via the mastoid route allowed removal of the infectious process and via the suprapetrous route allowed closure of the breaches in the bone and dura mater as well as treatment of associated cephaloceles, except in case of major infection where the cephalocele was closed in a second operation.
Aïdan
P
P
Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Beaujon, Faculté Xavier-Bichat, Université Paris, Clichy.
Ducroz
V
V
Julien
N
N
Sterkers
O
O
D000328:Adult; D018424:Cholesteatoma, Middle Ear / Q000150:complications; D002908:Chronic Disease; D004388:Dura Mater / Q000293:injuries; D004677:Encephalocele / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008279:Magnetic Resonance Imaging; D008297:Male; D010031:Otitis / Q000150:complications; D010579:Petrous Bone / Q000293:injuries; D011183:Postoperative Complications; D011559:Pseudotumor Cerebri / Q000150:complications; D012189:Retrospective Studies; D012886:Skull; D014057:Tomography, X-Ray Computed