Instituto de Otología Garcia-Ibanez, C/Dr. Roux 91, Bajos, Barcelona 08017, Spain.
Instituto de Otología Garcia-Ibanez, C/Dr. Roux 91, Bajos, Barcelona 08017, Spain.
Am J Otolaryngol. 2020 Jul-Aug;41(4):102560. doi: 10.1016/j.amjoto.2020.102560. Epub 2020 May 28.
Along the medical practice of an Otologist he/she will face middle cranial fossa (MCF) bone defects. The purpose of this study is to contribute to the understanding of this possible life threatening condition, and to share and discuss our management approach. A literature review is also presented.
Retrospective case series at García-Ibáñez Otology and Skull base private center referral.
This study is based on the analysis of data collected from 19 cases of temporal bone meningoencephalic herniations surgically treated from 2006 to 2018. The follow-up ranged from 18 to 162 months with a mean average of 44.5 months.
Meningoencephalic herniations were divided into four etiologic groups: spontaneous (24.8%), secondary to chronic otitis media (21.8%), iatrogenic (45.9%), and posttraumatic (7.5%). Different surgical techniques were used as treatment: transmastoid (TM) approach (27.8%), MCF approach (27.8%), combined technique (transmastoid plus minicraniotomy, 3%), and middle ear obliteration with blind sac closure of the external auditory canal (41.4%).
Variables like bilateral hearing level, size and location of the bone defect and existence of CSF leak should be analyzed to select the safest and most effective closing surgical approach.
耳鼻喉科医生在行医过程中会遇到中颅窝（MCF）骨缺损的情况。本研究旨在帮助理解这种可能危及生命的情况，并分享和讨论我们的治疗方法。本文还进行了文献回顾。
在加西亚-伊瓦涅斯耳鼻喉科和颅底私人中心的回顾性病例系列研究。
本研究基于对 2006 年至 2018 年间手术治疗的 19 例脑膜脑膨出的病例数据进行分析。随访时间为 18 至 162 个月，平均为 44.5 个月。
脑膜脑膨出分为四个病因组：自发性（24.8%）、慢性中耳炎继发（21.8%）、医源性（45.9%）和外伤性（7.5%）。采用不同的手术技术进行治疗：经乳突（TM）入路（27.8%）、MCF 入路（27.8%）、联合技术（经乳突加迷你颅切开术，3%）和中耳闭塞并封闭外耳道盲袋（41.4%）。
应分析双侧听力水平、骨缺损的大小和位置以及存在脑脊液漏等变量，以选择最安全有效的闭合手术入路。
