Abstract：
BACKGROUND:Temporal bone tegmen defects may be associated with cerebrospinal fluid (CSF) otorrhea. A variety of techniques have been used for repair. We report our experience with skull base reconstruction for tegmen defects using either autologous or alloplastic grafts. METHODS:A retrospective chart review was performed on patients with tegmen defects treated from 2007 to 2017 at the University Hospital in Columbia, Missouri, USA. Primary outcome measures were analyzed. RESULTS:Twenty-five patients were treated with a middle cranial fossa approach (median age 53, 88% females, median body mass index 34, median follow-up 9 months). Presenting symptoms included CSF leak (92%), hearing loss (44%), imbalance (12%), meningitis (12%), headache (4%), and tinnitus (4%). Most tegmen defects occurred spontaneously (84%) but cholesteatomas (4%), and trauma (12%) also were identified. Pre- and postoperative audiograms were available for 13 patients (52%); 7 (54%) showed objective improvement. Fourteen patients were repaired with autologous bone graft (56%), 7 with alloplastic grafts (28%), and 4 with temporalis fascia only (16%). All patients had resolution of CSF leak. Two patients (8%) suffered wound infections and 3 (12%) had facial and/or petrosal nerve complications. Use of alloplastic graft significantly shortened operative time (allopathic mean 180 minutes vs. autologous mean 208 minutes; P = 0.03). CONCLUSIONS:CSF otorrhea due to tegmen defects can be repaired via a middle fossa craniotomy using either an autologous or alloplastic graft with equivalent outcomes and efficacy, although alloplastic graft helps reduce operating time.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Hoang S,Ortiz Torres MJ,Rivera AL,Litofsky NSdoi
10.1016/j.wneu.2018.05.196subject
Has Abstractpub_date
2018-10-01 00:00:00pages
e10-e17eissn
1878-8750issn
1878-8769pii
S1878-8750(18)31150-1journal_volume
118pub_type
杂志文章abstract：BACKGROUND:Deep brain stimulation within or adjacent to the subthalamic nucleus (STN) represents the most common stereotactic procedure performed for Parkinson disease. Better STN imaging is often regarded as a requirement for improving stereotactic targeting. However, it is unclear whether there is consensus about the...
journal_title：World neurosurgery
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