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Published on: December 5, 2025
Vascularized mastoid bone flap cranioplasty after translabyrinthine vestibular schwannoma surgery
Heng-Wai Yuen1, Andrew L Thompson, Sean P Symons
1Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
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.
Study Design:
Retrospective study.
Setting:
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.
