Comparison of Outcomes of Surgical Repair of Spontaneous Temporal Bone CSF Leaks and Encephaloceles Using Bone Cement and Autologous Material

Hwa, Tiffany Peng; Patel, Vir; Eliades, Steven J.; Brant, Jason A.; Bigelow, Douglas C.; Ruckenstein, Michael J.

doi:10.1097/mao.0000000000003467

Cited by 2 publications

(2 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous literature has also looked at how hydroxyapatite cement can be used in different skull base approaches such as translabyrinthine, middle cranial fossa (MCF), and transmastoid (8)(9)(10). With regard to spontaneous temporal bone CSF leak repair specifically, previous literature has explored the efficacy of hydroxyapatite cement using the MCF repair approach and has found it to be effective (9).…”

Section: Introductionmentioning

confidence: 99%

“…With regard to spontaneous temporal bone CSF leak repair specifically, previous literature has explored the efficacy of hydroxyapatite cement using the MCF repair approach and has found it to be effective (9). Hydroxyapatite cement has also been compared with autologous material directly (n = 12-15 patients) and has been shown to have a shorter operating time with similar success rates (10). Given its growing popularity in use and relative advantages, we aimed to review our cohort spanning over 10 years to assess the utility of hydroxyapatite in the transmastoid approach for repair of CSF leaks and to identify the ideal population for this treatment.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hydroxyapatite Use in Repair of Lateral Skull Base CSF Leaks Via Transmastoid Approach: When Does It Work?

Shah¹,

Kveton

Schwartz

2023

Otol Neurotol

View full text Add to dashboard Cite

Objective The objective of this study is to evaluate the efficacy and outcomes of using a transmastoid approach with hydroxyapatite cement to repair lateral skull base cerebrospinal fluid (CSF) leaks. Study Design Retrospective cohort study. Setting Tertiary-level care hospital. Patients Surgical patients 18 years or older between 2013 and 2022 with spontaneous CSF leak. Interventions Trans-mastoid approach for skull base repair using hydroxyapatite cement. Main Outcome Measures Failure rate of repair; location and size of defect, patient demographic factors. Results Of the 60 total defects (55 patients, 5 bilateral repairs) that underwent CSF leak repair using hydroxyapatite cement, the success rate was 91.66% (55 successful repairs). The average defect size in unsuccessful repairs was 1.15 cm compared with 0.71 cm for successful repairs. In addition, 80% (4/5) of the failed repairs were in the tegmen tympani region. Higher failure rate was noted in women (3/5) and in former smokers (4/5). Average time to recurrent symptoms was 1.75 years in the failed repair cohort. Of the patients with failed repairs, 4/5 were prescribed acetazolamide before their second procedure with successful second repair. In addition, five patients experienced postoperative headaches, three (5.4%) of whom required placement of VP shunts to relieve increased intracranial pressure. Two patients (3.6%) had complications of either infection or hearing loss. Conclusions Transmastoid approach utilizing hydroxyapatite is a successful approach for CSF leak repair, with a low complication and failure rate. Women, prior smoking history, and larger defects in the tegmen tympani region may need alternative materials or approach for repair. Long follow-up is warranted as recurrence of symptoms might be delayed. In cases of benign intracranial hypertension, adjuvant treatment with either acetazolamide or VP shunt placement may prevent failures.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hydroxyapatite Use in Repair of Lateral Skull Base CSF Leaks Via Transmastoid Approach: When Does It Work?

Shah¹,

Kveton

Schwartz

2023

Otol Neurotol

View full text Add to dashboard Cite

show abstract

Middle ear secretions following spontaneous CSF leak repair may represent effusion rather than CSF leak

Ungar,

Chaushu,

Oron

et al. 2024

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Comparison of Outcomes of Surgical Repair of Spontaneous Temporal Bone CSF Leaks and Encephaloceles Using Bone Cement and Autologous Material

Abstract: Objective: To compare outcomes transmastoid repair of spontaneous middle fossa cerebrospinal fluid (CSF) leak using only bone cement (BC) versus only autologous material (AM) or combined materials (CM) with both bone cement and autologous material.

Cited by 2 publications

References 21 publications

Hydroxyapatite Use in Repair of Lateral Skull Base CSF Leaks Via Transmastoid Approach: When Does It Work?

Hydroxyapatite Use in Repair of Lateral Skull Base CSF Leaks Via Transmastoid Approach: When Does It Work?

Middle ear secretions following spontaneous CSF leak repair may represent effusion rather than CSF leak

Contact Info

Product

Resources

About