Vascularized mastoid bone flap cranioplasty after translabyrinthine vestibular schwannoma surgery.
OBJECTIVE
We describe a novel technique of cranioplasty using a vascularized mastoid bone flap in patients after translabyrinthine excision of vestibular schwannomas (VS). Postoperative outcomes in terms of pinna and postauricular deformity are evaluated.


METHODS
Retrospective study.


METHODS
Tertiary referral center.


RESULTS
Seventeen patients underwent cranioplasty with bone flap after translabyrinthine VS excision. At minimum follow-up of 12 months, none had a cerebrospinal fluid (CSF) leak. The measured pinna projections between the operated and non-operated sides had a mean difference of 0.80 mm (+/-1.70), which is not statistically significant (p > 0.05). The mean depth of the postauricular depressions was 1.38 mm (+/-0.93). Over the same period, 10 patients underwent translabyrinthine VS surgery without cranioplasty. In this group, there was a significant difference of 4.71 mm (+/-1.53) in mean pinna underprojections on the operated sides compared with the non-operated sides. Compared with patients who have undergone cranioplasty, the retroauricular depressions were significantly deeper (p < 0.05) with a mean depth of 2.92 mm (+/-1.21).


CONCLUSIONS
Vascularized mastoid cortical bone flap cranioplasty is a simple and effective technique to ameliorate the pinna and retroauricular deformities after translabyrinthine VS excision without increased surgical cost or the use of alloplastic materials.
Yuen
Heng-Wai
HW
Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Thompson
Andrew L
AL
Symons
Sean P
SP
Pirouzmand
Farhad
F
Chen
Joseph M
JM