Tolisano Anthony M, Kutz Joe Walter
Department of Otolaryngology, Southwestern Medical Center, University of Texas, Dallas, Texas, USA.
Curr Opin Otolaryngol Head Neck Surg. 2019 Oct;27(5):356-360. doi: 10.1097/MOO.0000000000000560.
The aim of this article is to describe the middle fossa craniotomy (MFC) approach for the repair of cerebrospinal (CSF) fistula and encephaloceles.
The MFC approach has a greater than 93% success rate for managing CSF fistula and encephaloceles located along the tegmen tympani and tegmen mastoideum. Posterior fossa defects cannot be managed by an MFC approach. Multilayer repair with the combination of soft tissue and durable substances is preferred. Hydroxyapatite bone cement provides a durable repair of thinned or absent areas of bone with a low risk of infection. Concurrent management of symptomatic superior semicircular canal dehiscence may be readily performed. Small keyhole craniotomies with the utilization of the endoscope are possible as a means to minimize temporal lobe retraction.
MFC repair of CSF fistula and encephaloceles is a highly effective approach for the repair of tegmen mastoideum and tegmen tympani defects.
本文旨在描述用于修复脑脊液（CSF）瘘和脑膨出的中颅窝开颅术（MFC）方法。
MFC方法对于处理位于鼓室盖和乳突盖的CSF瘘和脑膨出成功率超过93%。后颅窝缺损无法通过MFC方法处理。软组织和耐用材料联合的多层修复是首选。羟基磷灰石骨水泥能对变薄或缺失的骨区域进行持久修复，感染风险低。可同时轻松处理有症状的上半规管裂。利用内窥镜进行小骨窗开颅术是尽量减少颞叶牵拉的一种方法。
MFC修复CSF瘘和脑膨出是修复乳突盖和鼓室盖缺损的高效方法。
