Feenstra L, Sanna M, Zini C, Gamoletti R, Delogu P
Am J Otol. 1985 Jul;6(4):311-5.
A series of thirty-five patients operated on for brain herniation into the middle ear and mastoid is presented. The etiologic factor was felt to be previous surgery in twenty-six cases, head trauma in four cases, chronic otomastoiditis in four cases, congenital dehiscence of the tegmen in one case, and subdural empyema in one case. Diagnosis and treatment of brain herniation are discussed. The mastoid approach for repair of tegmen defects from below with the use of homologous cartilage or autologous cortical bone is advocated. A combined procedure using the transmastoid approach plus a mini-craniotomy of the temporalis squama is suggested as an alternative treatment to middle cranial fossa repair for larger cerebral hernias.
本文报告了35例因脑疝入中耳和乳突而接受手术的患者。病因被认为是：26例为既往手术史，4例为头部外伤，4例为慢性耳乳突炎，1例为先天性鼓室盖裂，1例为硬脑膜下积脓。文中讨论了脑疝的诊断和治疗。提倡采用乳突入路，利用同种异体软骨或自体皮质骨从下方修复鼓室盖缺损。对于较大的脑疝，建议采用经乳突入路联合颞鳞部微型开颅术作为中颅窝修复术的替代治疗方法。
