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DOI: 10.1055/s-2008-1058978
© Thieme Medical Publishers, Inc., 381 Park Avenue South, New York, NY 10016
Spontaneous Cerebrospinal Fluid Leaks in Congenital and Acquired Temporal Bone Defects - Long-Term Follow-Up
Publication History
Publication Date:
03 March 2008 (online)
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Abstract
Twelve patients presenting with tegmen defects and requiring surgical repair were retrospectively reviewed from 1982 to 1993. One half of the patients presented with a cerebrospinal fluid leak at some time in the course of their illness. Nine cases were considered to be acquired, secondary to previous mastoid surgery or trauma. All 9 had encephalocoeles. Three spontaneous leaks were considered congenital; 2 of these patients had encephalocoeles. This report represents a long-term follow-up of these cases, with an average follow-up of 7,6 years. Computed tomography and magnetic resonance imaging technology, as well as contrast studies, have tremendously aided in diagnosis and planning of surgical repair. Nine repairs were done through a dual transmastoid and middle fossa approach, with the other 3 done via a transmastoid approach only. We favored temporalis muscle flaps and temporalis fascia over synthetic materials for defect repairs. The long-term results and complications are discussed.