Combined Approach for Temporal Bone Defect Repair in Subjects with Cerebrospinal Fluid Otorrhea or Herniations

Objectives: To describe our departmental experience in the surgical repair of tegmen tympani defects, using a combined transmastoid/minicraniotomic approach. Study Design: Retrospective review of videos from surgery and patients' charts. Setting: Tertiary university referral center. Participants: A total of 22 subjects who underwent surgical repair of tegmental 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: Total 22 subjects underwent the combined approach and all 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.