title: Combined approach for tegmen defects repair in patients with cerebrospinal fluid otorrhea or herniations: our experience.
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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Marchioni
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Bonali
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Alicandri-Ciufelli
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Rubini
authors.affiliation: Department of Neurosurgery, New Civil Hospital Sant'Agostino-Estense, Baggiovara (MO), Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Pavesi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
authors.forename: Livio
authors.initials: L
authors.lastname: Presutti
keywords: cerebrospinal fluid leakage; encephalocele; meningocele; middle cranial fossa approach; tegmen tympani
references.citation: Am J Otol. 1999 Nov;20(6):770-6
references.pmid: 10565723
references.citation: Skull Base Surg. 1995;5(1):1-7
references.pmid: 17171151
references.citation: Laryngoscope. 2009 Aug;119(8):1579-85
references.pmid: 19479744
references.citation: Acta Otolaryngol. 2011 Apr;131(4):391-4
references.pmid: 21314244
references.citation: Otolaryngol Head Neck Surg. 2006 May;134(5):767-71
references.pmid: 16647532
references.citation: Laryngoscope. 2008 Dec;118(12):2195-9
references.pmid: 19029865
references.citation: Otol Neurotol. 2007 Dec;28(8):1120-3
references.pmid: 18043437
references.citation: Clin Otolaryngol Allied Sci. 2001 Apr;26(2):117-23
references.pmid: 11309052
references.citation: Am J Otolaryngol. 2011 Mar-Apr;32(2):135-40
references.pmid: 20392531
references.citation: Arch Otolaryngol Head Neck Surg. 2008 May;134(5):509-18
references.pmid: 18490573
references.citation: Laryngoscope. 2004 May;114(5):800-5
references.pmid: 15126733
references.citation: Am J Otolaryngol. 2012 Sep-Oct;33(5):556-61
references.pmid: 22386112
references.citation: Otolaryngol Head Neck Surg. 2007 Jun;136(6):961-5
references.pmid: 17547988
references.citation: Clin Radiol. 2010 Oct;65(10):832-41
references.pmid: 20797470
references.citation: Clin Otolaryngol Allied Sci. 2000 Oct;25(5):385-91
references.pmid: 11012652
references.citation: J Laryngol Otol. 2008 Nov;122(11):1168-74
references.pmid: 18346291
references.citation: Otol Neurotol. 2005 Nov;26(6):1171-5
references.pmid: 16272936
references.citation: Am J Otol. 1996 May;17(3):461-9
references.pmid: 8817026
references.citation: Ear Nose Throat J. 2000 May;79(5):372-3, 376-8
references.pmid: 10832203
references.citation: Laryngoscope. 2011 Aug;121(8):1765-72
references.pmid: 21647915
references.citation: Otol Neurotol. 2007 Dec;28(8):1131-9
references.pmid: 17921911
references.citation: ORL J Otorhinolaryngol Relat Spec. 2005;67(1):51-5
references.pmid: 15753623
references.citation: Laryngoscope. 1979 Nov;89(11):1743-54
references.pmid: 502695
references.citation: Otol Neurotol. 2012 Oct;33(8):1412-7
references.pmid: 22918116
references.citation: Am J Otol. 1997 Mar;18(2):198-205; discussion 205-6
references.pmid: 9093677
references.citation: Ann Otol Rhinol Laryngol. 1990 Nov;99(11):854-62
references.pmid: 2241009
references.citation: Ear Nose Throat J. 2005 Nov;84(11):700, 702-4, 706
references.pmid: 16381132