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Temporal bone encephalocele and cerebrospinal fluid leaks
L B Lundy1, M D Graham, J M Kartush
1Michigan Ear Institute, Farmington Hills 48334, USA.
The American Journal of Otology
|May 1, 1996
Summary
Temporal bone brain herniation and cerebrospinal fluid (CSF) leaks can be diagnosed clinically. Surgical repair using a fascia-bone-fascia technique is effective and safe, with no reported complications.
Area of Science:
- Neurosurgery
- Otolaryngology
Background:
- Temporal bone brain herniation and cerebrospinal fluid (CSF) leaks are rare but serious conditions.
- These leaks can be spontaneous, related to chronic otitis media, or posttraumatic.
Purpose of the Study:
- To review cases of temporal bone brain herniation and CSF leaks.
- To evaluate diagnostic methods and surgical repair techniques.
- To assess surgical outcomes and complications.
Main Methods:
- Retrospective review of 19 cases in 17 adult patients since 1987.
- Analysis of patient demographics, etiology, diagnostic methods, surgical approaches, and repair techniques.
- Evaluation of follow-up data regarding complications and repair success.
Main Results:
- 11 spontaneous, 6 chronic otitis media-related, and 2 posttraumatic CSF leaks were identified.
- The average patient age was 51.2 years.
- Diagnosis was primarily clinical (18/19 cases); ancillary tests offered limited value.
- Combined transmastoid and middle fossa craniotomy was the most common surgical approach (16/19 cases).
- The fascia-bone-fascia technique was preferred for defect repair (10/19 cases).
- No surgery-related complications occurred, and all repairs were successful in one stage.
Conclusions:
- Clinical diagnosis is reliable for temporal bone brain herniation and CSF leaks.
- The combined transmastoid and middle fossa approach with fascia-bone-fascia repair is a safe and effective treatment.
- One-stage surgical repair can achieve definitive closure without complications.