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Endoscopic Middle Cranial Fossa Reconstruction with a Subtemporal Keyhole
Fuminari Komatsu1, Masaaki Imai1, Akihiro Hirayama1
1Department of Neurosurgery, Tokai University Hachioji Hospital, Tokyo, Japan.
World Neurosurgery
|September 5, 2017
Summary
A minimally invasive endoscopic technique for middle cranial fossa reconstruction using a vascularized deep temporal fascia flap through a subtemporal keyhole successfully repaired cerebrospinal fluid leakage. This approach offers a reliable solution for skull base defects.
Area of Science:
- Neurosurgery
- Skull Base Surgery
- Minimally Invasive Techniques
Background:
- Cerebrospinal fluid (CSF) leakage from the skull base requires effective reconstruction.
- Minimally invasive methods for middle cranial fossa (MCF) reconstruction are lacking.
- This study presents a novel endoscopic approach for MCF repair.
Observation:
- A patient with spontaneous CSF leakage underwent endoscopic MCF reconstruction via a subtemporal keyhole.
- A vascularized deep temporal fascia (DTF) flap was utilized for defect coverage.
- Indocyanine green angiography confirmed flap vascularity.
Findings:
- The endoscopic technique successfully reconstructed the MCF through a subtemporal keyhole.
- The vascularized DTF flap provided reliable coverage of the bone defects.
- The patient experienced complete resolution of CSF leakage without complications.
Implications:
- This purely endoscopic technique offers a reliable and minimally invasive option for MCF reconstruction.
- The approach is potentially applicable to MCF reconstruction following skull base tumor surgery.
- Further research may validate this technique for broader clinical use.
