Agrawal Amit, Baisakhiya Nitish, Deshmukh P T
Datta Meghe Institute of Medical Sciences, Sawangi, Meghe, Wardha, Maharashtra India.
Indian J Otolaryngol Head Neck Surg. 2011 Jul;63(Suppl 1):142-6. doi: 10.1007/s12070-011-0174-1. Epub 2011 Apr 10.
Cerebrospinal fluid (CSF) otorrhoea is an uncommon condition arising from defects in the tegmen and middle cranial fossa. 33 year gentleman presented with post-mastoidectomy CSF otorrhoea of 5 year duration. Imaging finding were suggestive of fracture in the tegmen region. A combined middle cranial fossa/transmastoid was used to repair the defect. Defect was identified in the tegmen plate and it was closed with pedicled pericranial graft, laterally based pedicled temporalis muscle graft reinforced by bone dust and supported with intact mucosal flap. The leak stopped completely following surgery. The patient is doing well at follow up. Repair of these defects need careful analysis of imaging findings to understand pathological anatomy, and a well planned surgical approach to achieve meticulous repair.
脑脊液耳漏是一种由中颅窝顶和中耳盖缺陷引起的罕见病症。一名33岁男性患者，乳突切除术后出现脑脊液耳漏，病程长达5年。影像学检查结果提示中耳盖区域骨折。采用中颅窝联合经乳突入路修复缺损。在中耳盖骨板处发现缺损，并用带蒂颅骨膜瓣修补，外侧带蒂颞肌瓣用骨粉加固，并由完整的黏膜瓣支撑。术后漏液完全停止。患者随访情况良好。修复这些缺损需要仔细分析影像学检查结果以了解病理解剖结构，并采用精心规划的手术方法进行精细修复。
