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Brain herniation and space-occupying lesions eroding the tegmen tympani
A K Bowes1, R J Wiet, E M Monsell
1Department of Otolaryngology/Head and Neck Surgery, Loyola University, IL.
The Laryngoscope
|October 1, 1987
Summary
Brain hernia diagnosis and management have improved with advances in neuroradiology and skull base surgery. Early suspicion in chronic ear surgery patients with pulsatile masses and CSF leaks is key for effective treatment.
Area of Science:
- Neurosurgery
- Otolaryngology
- Neuroradiology
Background:
- Advances in neuroradiology and skull base surgery enhance diagnosis and management of tegmen tympani lesions.
- Brain hernia should be suspected in patients with a history of complicated chronic ear surgery presenting with a pulsatile mass and CSF leak.
Observation:
- Patients require evaluation in an upright position using an otomicroscope and magnetic resonance imaging (MRI).
- Over a 6-year period, seven patients with eight space-occupying lesions eroding the tegmen were treated.
Findings:
- Surgical repair methods included temporalis muscle flaps (5 lesions), fascia and bone (2 lesions), and Marlex (1 lesion).
- The study reviews new diagnostic technologies and modified surgical techniques for brain hernia.
Implications:
- Improved diagnostic accuracy and surgical techniques lead to better outcomes for tegmen tympani defects.
- This research contributes to the understanding and treatment of brain herniation through the tegmen tympani.