Meningoencephalocele of the temporal bone: Pictorial essay on transmastoid extradural-intracranial repair

Manjila, Sunil; Wick, Cameron C.; Cramer, John D.; Semaan, Maroun T.; Bambakidis, Nicholas C.; Selman, Warren R.; Megerian, Cliff A.

doi:10.1016/j.amjoto.2013.05.004

Cited by 6 publications

(3 citation statements)

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“…The study aims to assess the outcomes of patients undergoing each of these approaches and whether there is a difference in cost between the TM and MCF approaches. A number of authors have previously described the TM approach as effective for the treatment of this pathology (1,2,5–8,10–13). Our results agree that for most defects, a TM approach is a reasonable first choice with the patient being aware that a MCF surgery may be necessary if the initial operation is unsuccessful.…”

Section: Discussionmentioning

confidence: 99%

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Comparing Outcomes and Billing Costs of Middle Cranial Fossa and Transmastoid Approaches for Otogenic Encephalocele and Cerebrospinal Fluid Leak Repair

et al. 2022

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ObjectiveComparison of outcomes and billing costs of patients treated at our institution using transmastoid (TM), middle cranial fossa (MCF), and combined approaches for repair of otogenic cerebrospinal fluid (CSF) leaks and encephaloceles.Study DesignRetrospective cohort review.SettingTertiary-care hospital.PatientsSeventy-seven cases of otogenic CSF leaks or encephaloceles.InterventionsSurgical repair of an otogenic encephalocele or CSF leak using either a TM, MCF, or combined approach.Main Outcome MeasuresSuccess of repair, length of operation, cost of operating room materials, postoperative need for intensive care, and postoperative length of stay.ResultsForty cases (52%) were performed by the TM approach, 27 (35%) by MCF, and 10 (13%) by combined TM/MCF. Mean length of stay was not statistically different amongst TM patients (2.1 d), MCF patients (3.3 d), and combined TM/MCF patients (3.70; p = 0.112). Only 3/40 TM cases required intensive care during their admission while all MCF and combined TM/MCF approach cases were admitted to the intensive care unit for at least one night (p < 0.001). On follow-up, CSF leak recurred in 3/77 (4%) cases: 3/27 (11%) MCF, 0/40 TM, and 0/10 combined TM/MCF patients (p = 0.056). The mean cost of operating room materials charged to the patient was significantly greater in the MCF group ($9,883) than the TM group ($3,748; p = 0.001).ConclusionsIn carefully selected patients, the TM approach is an effective and less costly alternative to MCF approaches for repair of otogenic CSF leaks and encephaloceles.

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Section: Discussionmentioning

confidence: 99%

“…The middle cranial fossa approach (MCF) and the transmastoid approach (TM) are two commonly used surgical techniques for repair of temporal bone skull base defects (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Advantages of the MCF approach include a broad exposure of the lateral skull base and low risk of injury to the structures involved with hearing (3,4,8,9).…”

mentioning

confidence: 99%

Comparing Outcomes and Billing Costs of Middle Cranial Fossa and Transmastoid Approaches for Otogenic Encephalocele and Cerebrospinal Fluid Leak Repair

et al. 2022

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“…Meningoencephalocelen im Bereich des Felsenbeins können entweder kongenital, durch Fehlentwicklung des Schädels und fehlender Ossifikation der petrosquamösen Verbindung, oder erworben z. B. bei Adipositas, intrakranieller Hypertension, oder durch einen wachsenden Frakturspalt nach Felsenbeinfraktur vorliegen [3,4]. Des Weiteren stellen Meningoencephalocelen auch eine sehr seltene Komplikation nach chirurgischen Eingriffen am Felsenbein dar [5]…”

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