Tegmen Tympani Defect and Brain Herniation Secondary to Mastoid Surgery: Case Presentation

Eğilmez, Oğuz Kadir; Hanege, Fatih Mehmet; Kalcıoğlu, M. Tayyar; Kaner, Tuncay; Kökten, Numan

doi:10.1155/2014/756280

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…A sebészi beavatkozás típusa függ az elváltozás méretétől, helyétől, a társuló fülfolyamatoktól, a beteg hallásától és a sebész tapasztalatától [17]. A patológiás folyamat műtétileg elérhető középső skála craniotomiás feltáráson át, mini középső skála behatolásból, transmastoid behatolásból vagy kombinált középső skálatransmastoid behatolásokból is [15,18]. A dura, illetve csonthiány pótolható autológ, heterológ vagy alloplasztikus anyagokkal vagy ezek kombinációjával [19].…”

Section: Megbeszélésunclassified

Középső skálába terjedő, temporalis csontból kiinduló koleszteringranuloma

et al. 2019

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The authors present a case report of a patient who was treated conservatively for a non-specific headache for more than a decade, while an arachnoidal cyst in the middle cranial fossa, over the temporal bone tegmen was diagnosed, but ruled out as the cause of the headache. The patient was referred to our ENT department with left, purulent ear discharge. Besides a chronic purulent otitis media, a cholesterol granuloma occupying the antrum, eroding the tegmen of the pyramid bone and penetrating into the middle cranial fossa was diagnosed. Case presentation of a patient with cholesterol granuloma, surgical options, differential diagnostic problems, and a literature review are presented. Tympanoplasty with cortical mastoidectomy was carried out to treat the chronic purulent otitis media, and the cholesterol granuloma was removed during transmastoid craniotomy. The iatrogenic temporal meningo-encephalic tissue herniation was repaired and the bone defect of the tegmen was reconstructed with septal cartilage. The patient’s headache diminished immediately after the surgery. The chronic ear discharge stopped, the cholesterol granuloma was excised completely and the cerebral herniation was repaired successfully. Neither CSF leak, nor further herniation or meningitis were noticed. Two years after the operation the patient is asymptomatic. A large cholesterol granuloma, eroding into the middle cranial fossa can cause serious complications, and needs a high level of attention besides individualized surgical treatment based on the surgeon’s abilities and skills. Orv Hetil. 2019; 160(52): 2067–2072.

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Section: Megbeszélésunclassified

Középső skálába terjedő, temporalis csontból kiinduló koleszteringranuloma

et al. 2019

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“…Tegmen defects may result from congenital skull base defects, chronic otitis media (COM), neoplasms, and fractures, or may present as surgical complications (Egilmez et al, 2014;Singh et al, 2020). Any damage to the tympanic plate can lead to otorrhea and meningoencephaloceles.…”

Section: Introductionmentioning

confidence: 99%

“…Repair of tegmen dehiscence requires complicated treatment because of the need for adequate bone, cartilage, and fascia support, or placement of composite grafts. Such complications may be repaired by transmastoid surgery or a more complicated middle cranial surgical approach (Neely & Kuhn, 1985;Kuhweide & Casselman, 1999;Weber, 2005;Egilmez et al, 2014). Whether surgery is undertaken to treat the aforementioned conditions or iatrogenic complications, the essential point to prevent negative outcomes in patients is proper knowledge of the anatomy and preoperative radiological evaluation.…”

Section: Introductionmentioning

confidence: 99%

Anatomical and Clinical Evaluation of Tympanic Tegmen and Mastoid Bone with Multidetector Computed Tomography

Sever,

Çetin,

Çalıskan

et al. 2023

Int. J. Morphol.

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Tegmen level and mastoid bone thickness are important parameters of surgical risk in middle ear and mastoid region surgeries. This retrospective cohort study was conducted to provide a risk classification for the mastoid and middle ear regions. The study population comprised of 300 patients who underwent multidetector computed tomography (MDCT) for various indications. Patients with no pathology that disrupted the structure of the temporal region were included in the study. A risk classification was generated by analyzing the data obtained from mastoid and tympanic tegmen depths and the mastoid bone thickness by MDCT. The mastoid and tympanic tegmen were lower on the right side than on the left. In women, the right-sided mastoid bone thickness and mastoid tegmen were lower, and low-level tympanic and mastoid tegmen on the left and thin right mastoid bones were more common. According to the risk classifications for mastoid and middle ear region surgeries, women demonstrated a higher risk than men. In addition, as the thickness of the mastoid bone increased, the levels of the mastoid and tympanic tegmen increased. The present study provides a proper risk classification that may be helpful for preoperative risk assessment prior to middle ear and mastoid region surgery.

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Grading of the Position of the Mastoid Tegmen in Human Temporal Bones – A Surgeon’s Perspective

et al. 2020

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The Journal of International Advanced Otology (J Int Adv Otol) is an international, peer reviewed, open access publication that is fully sponsored and owned by the European Academy of Otology and Neurotology and the Politzer Society. The journal is published triannually in April, August, and December and its publication language is English. The scope of the Journal is limited with otology, neurotology, audiology (excluding linguistics) and skull base medicine. The Journal of International Advanced Otology aims to publish manuscripts at the highest clinical and scientific level. J Int Adv Otol publishes original articles in the form of clinical and basic research, review articles, short reports and a limited number of case reports. Controversial patient discussions, communications on emerging technology, and historical issues will also be considered for publication. Target audience of J Int Adv Otol includes physicians and academics who work in the fields of otology, neurotology, audiology and skull base medicine.

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Tegmen Tympani Defect and Brain Herniation Secondary to Mastoid Surgery: Case Presentation

Cited by 3 publications

References 11 publications

Középső skálába terjedő, temporalis csontból kiinduló koleszteringranuloma

Középső skálába terjedő, temporalis csontból kiinduló koleszteringranuloma

Anatomical and Clinical Evaluation of Tympanic Tegmen and Mastoid Bone with Multidetector Computed Tomography

Grading of the Position of the Mastoid Tegmen in Human Temporal Bones – A Surgeon’s Perspective

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