Combined Mastoid/Middle Cranial Fossa Repair of Temporal Bone Encephalocele
Combined Mastoid/Middle Cranial Fossa Repair of Temporal Bone Encephalocele
复制标题
乳突/中颅窝联合修复颞骨脑膨出
DOI：
10.1055/s-2008-1058181
复制
发表时间：
1998
期刊：
影响因子：
--
通讯作者：
A. Langman
中科院分区：
文献类型：
--
作者：
Charles R. Souliere Jr.;A. Langman
颞骨脑膨出（TBE）已变得不太常见，因为慢性乳突感染的发病率和手术治疗这种情况已经减少。由于其发病率下降，TBE的诊断可能会延迟，并导致严重的并发症，如脑脊液漏，脑膜炎，硬膜外或硬膜下脓肿的发展。本文报告了6例不同病因的大（>1 cm）TBE。两名患者有颞骨骨折史，两名患者有乳突切除术史，两名患者有长期慢性乳突炎史。2例患者既往接受过不成功的经乳突修复术。所有患者均采用自体筋膜、骨和/或软骨成功修复硬膜-硬膜，主要通过乳突-中颅窝联合入路。准确的硬脑膜闭合和颅内内容物的支持是防止复发的必要条件。我们发现永久性修复最好采用乳突中颅筋膜联合入路。
Temporal bone encephalocele (TBE) has become less common as the incidence of chronic mastoid infection and surgery for this condition has decreased. Due to its declining incidence, the diagnosis of TBE may be delayed and result in the development of serious complications such as cerebrospinal fluid leak, meningitis, epidural or subdural abscess. Six cases of large (>1 cm) TBE of diverse etiology are described. Two patients had suffered previous temporal bone fractures, two had had prior mastoidectomy, and two patients had long-standing chronic mastoiditis. Two patients had undergone prior unsuccessful transmastoid repair. All patients underwent successful tegmen-dural repair with autogenous fascia, bone, and/or cartilage, primarily via a combined mastoid-middle fossa approach. Accurate dural closure and support of intacranial contents are imperative to prevent recurrence. We find that permanent repair can best be performed with a combined mastoid middle cranial fassa approach.