Tegmen tympani cerebrospinal fluid leak repair.
OBJECTIVE
To describe the transmastoid approach for closing cerebrospinal fluid leaks in the tegmen tympani using autologous materials (temporal muscle fascia and abdominal fat) and heterologous materials (bovine collagen), together with its advantages and disadvantages.


METHODS
We present the cases of three patients who underwent closure of spontaneous cerebrospinal fluid leaks in the tegmen tympani in which we used the transmastoid approach and autologous and heterologous materials. The three patients underwent canal wall-up mastoidectomy, posterior tympanotomy, removal of the malleus head and incus and, consequently, exposure of the tegmen tympani and the cerebrospinal fluid leak. Closure was performed using temporal muscle fascia, abdominal fat and bovine collagen, fixed in place with fibrin glue. A lumbar shunt was established, as is routine.


RESULTS
The cerebrospinal fluid leak was closed in all patients using the technique described, with a minimum follow-up of 14 months.


CONCLUSIONS
The technique presented herein is an excellent option in cases of cerebrospinal fluid leakage in the tegmen tympani; it is easy to perform and results in minimal risk to patients.
Bento
Ricardo Ferreira
RF
Department of Otorhinolaryngology, Medical School, University of São Paulo, São Paulo, Brazil. rbento@attglobal.net
Pádua
Francini Grecco de Melo
FG
D000273:Adipose Tissue / Q000637:transplantation; D000328:Adult; D018786:Bone Substitutes; D002558:Cerebrospinal Fluid Otorrhea / Q000601:surgery*; D005205:Fascia / Q000637:transplantation; D005260:Female; D005402:Fistula / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures; D013701:Temporal Bone / Q000601:surgery*
D018786:Bone Substitutes