Citation Information :
Garavello W, Gaini L, Zanetti D. Transmastoid Repair of Temporal Meningoencephaloceles and Cerebrospinal Fluid Otorrhea. Int J Otorhinolaryngol Clin 2011; 3 (1):31-41.
This paper reviews the diagnosis and treatment of temporal bone meningoencephaloceles, defined as the herniation of meninges or brain tissue into empty spaces within the temporal bone, i.e. tympanic or mastoid cavity, through the tegmen tympani or antri respectively. It also describes the current methods of control of cerebrospinal fluid (CSF) leaks, which commonly present as serous otorrhea or rhinorrhea in addition to a variety of symptoms, such as conductive hearing loss. Imaging is the mainstay of the diagnostic process. Management of the condition is surgical, and this review outlines the surgical options with special emphasis on the transmastoid approach and the materials applicable for repair of the bony dehiscences.
Etiopathogenesis and type of congenital malformations observed in Kinshasa (Zaïre). J Gynecol Obstet Biol Reprod (Paris) 1990;19:955–61.
Pneumocephalus associated with aqueductal stenosis: Three-dimensional computed tomographic demonstration of skull-base defects. Childs Nerv Syst 2000;16:1–3.
External auditory canal meningoencephalocele with spontaneous cerebrospinal otorrhea. Otolaryngol Head Neck Surg 2008;139:478–79.
Lethal intracranial complications following inflation in the external auditory canal in treatment of serous otitis media and due to defects in the petrous bone. Acta Otolaryngol 1965;60:407–21.
Brain herniation and chronic otitis media: Diagnosis and surgical management. Clin Otolaryngol 2000;25:385–91.
High incidence of complications encountered in chronic otitis media surgery in a US metropolitan public hospital. Otolaryngol Head Neck Surg 2001;125: 623–27.
Brain herniation into the middle ear: Two idiopathic cases treated by a combined intracranial-mastoid approach. Laryngoscope 1989;99:950–54.
Repair of iatrogenic temporal lobe encephalocele after canal-wall-down mastoidectomy in the presence of active cholesteatoma. Otol Neurotol 2005;26: 587–94.
Brain herniation into the middle ear following temporal bone fracture. Acta Otolaryngol 2005;125:902–05.
Alloplastic materials in skull base reconstruction. In: Sekhar LN, Janecka JP (Eds). Surgery of cranial base tumors: A color atlas. New York, Raven Pr, USA 1993.
Mastoiditis and brain hernia (mastoiditis cerebri). Laryngoscope 1978;88: 1097–106.
Management of large dural defects in skull base surgery: An update. Laryngoscope 1990;100:200–02.
The use of the temporoparietal fascial flap in temporal bone reconstruction. Am J Otol 1996;17:42.
Resorption of composite polymerhydroxyapatite membranes: A time-course study in the rabbit. Biomaterials 1977;3:629–33.
Free rectus abdominis muscle flap reconstruction of the middle and posterior cranial base. Plast Reconstr Surg 1986;78:471–77.
Stainless steel wire mesh in the repair of small cranial defects. Ann Surg 1945:121:821–25.
The Hong Kong vascularised temporalis fascia flaps for optimal mastoid cavity reconstruction. Rev Laryngol Otol Rhinol (Bord) 1995;116: 57–60.
Management of meningoencephalic herniation of the temporal bone: Personal experience and literature review. Laryngoscope 2009;119: 1579–85.
Meningoencephalic herniation into the middle ear: A report of 27 cases. Laryngoscope 1995;105: 512–18.
Surgical management of brain tissue herniation into the middle ear and mastoid. Laryngoscope Nov 1979;89(11): 1743–54.
Middle cranial fossa approach for the repair of spontaneous cerebrospinal fluid otorrhoea using autologous bone pate. Clin Otolaryngol Allied Sci 2001;26: 117–23.
Mastoid obliteration. Otolaryngol Clin North Am 2006;39:1129–42.
Postauricular periosteal-pericranial flap for mastoid obliteration and canal walldown tympanomastoidectomy. Otol Neurotol 2004;25: 873–78.
Management of temporal bone meningoencephalocoele. J Laryngol Otol 2008;122:1168–67.
Transmastoid repair of minor skull base defects with flexible hydroxyapatite sheets. Skull Base 2003;13:1–11.
Bone regeneration at rabbit skull defects treated with transforming growth factor-beta1 incorporated into hydrogels with different levels of biodegradability. J Neurosurg 2000;92:315–25.
CO2 laser fascia to dura soldering for pig dural defect reconstruction. Skull Base 2007;17:17–23.
Comparative dural closure techniques: A safety study in rats. Surg Neurol 2006;65:42–47.
A new porcine skull base model: Fibrin glue improves strength of cerebrospinal fluid leak repairs. Otolaryngol Head Neck Surg 2009;141:184–89.
Cranioplasty with split lateral skull plate segments for reconstruction of skull defects. J Craniomaxillofac Surg 1998;26:379–85.
Use of microvascular free-tissue transfer following ablative surgery of the skull base. J Reconstr Microsurg 2000;16:3–6.
Skull base reconstruction. Curr Opin Otolaryngol Head Neck Surg 2003;11:282–90.
Use of the radial forearm microvascular free-flap graft for cranial base reconstruction. J Neurosurg 1999;90:651–55.
Microvascular reconstruction of the skull base: A clinical approach to surgical defect classification and flap selection. Skull Base 2007;17:5–15.
Titanium in cranioplasty. J Neurosurg 1965;22:292–93.
Cranioplasty with acrylic plates. J Neurosurg 1946;3:199–205.
Titanium mesh and acrylic cranioplasty. Neurosurgery 1989;25:351–55.
Selection of biomaterials for middle and inner ear implants. Otolaryngol Clin North Am 1995;28:17–27.
Problems in alloplastic middle ear reconstruction. Acta Otolaryngol (Stockh) 1992;112:322–27.
Tissue integration of the collagen-hydroxylapatite implant: Histological examination in canine bone and surrounding tissues. Eur Arch Otorhinolaryngol 1991;248:337–41.
Physicochemical characteristics of ceramics for medical applications. In: Pizzoferrato PG, Marchetti A, Ravaglioli A, Lee AJC (Eds). Biomaterials and Clinical Applications. Amsterdam: Elsevier Science Pub 1987.
Physico-chemical characterization of hydroxyapatite of unknown manufacture. In: Ravaglioli A, Krajewski A, et al (Eds). Bioceramics and the Human Body. Faenza, Italy: Gruppo Editoriale Faenza 1991.
Interface between hydroxyapatite and mandibular human bone tissue. Biomaterials 1992;13:162–66.
Interfacial study of some inert and active ceramics implanted in bone. In: Ravaglioli A, Krajewski A (Eds). Bioceramics and the Human Body. London, UK: Elsevier Applied Science 1991.
Hydroxylapatite: A morphological study. In: Babighian G, Veldman JE (Eds). Transplants and Implants in Otology. Amsterdam: Kugler and Ghedini 1988.
Surgical management of dural and temporal lobe herniation into the radical mastoid cavity. Laryngoscope 1982;92:329–31.
Brain herniation and space-occupying lesions eroding the tegmen tympani. Laryngoscope 1987;97:1172–75.
Hernies méningoencéphaliques et brèches du tegmen: Diagnostic et cure chirurgicale. Ann Otolaryngol (Paris) 1991;108:149–56.
Temporal bone encephalocele and cerebrospinal fluid leaks. Am J Otol 1996;17:461–69.
Combined mastoid middle cranial fossa repair of temporal bone encephalocele. Skull Base Surg 1998;8:185–89.
A method of cranioplasty using coralline hydroxyapatite. Pediatr Neurosurg 1998;29: 324–27.
A new technique for cranioplasty with L-shaped titanium plates and combination ceramic implants composed of hydroxyapatite and tricalcium phosphate (Ceratite). Neurosurgery 2000;46:414–18.