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Year: 2003  Vol. 7   Num. 4  - Oct/Dec Print:
Case Report
Texto Text in Portuguese
Transmastoid Approach for the Repair of Tegmen Tympani Cerebrospinal Fluid Leaks
Abordagem Transmastodea de Fstulas Liquricas em Tegmen Timpnico
Ricardo Ferreira Bento*, Francini Grecco de Melo Pdua**.
Key words:
transmastoid approach, cerebrospinal fluid leak, tegmen tympani.

Introduction: Otological cerebrospinal fluid leaks may result from congenital or acquired causes and usualy need a surgical intervention. Objective: To describe the transmastoid approach for closing cerebrospinal fluid leaks in the tegmen tympani using autologous materials (temporal muscle fascia and abdominal fat) and heterologous materials (bovine collagen) and to discuss its advantages and disadvantages. Method: Three patients underwent canal wall-up mastoidectomy, posterior tympanotomy, removal of the malleus head and incus, and, consequently, exposure of the tegmen tympani and the cerebrospinal fluid leak. The closure was made using temporal muscle fascia, abdominal fat, and bovine collagen, fixed in place with fibrin glue. A lumbar shunt was routinely established. Results: The cerebrospinal fluid leak was closed in all patients after the use of the technique described, with a minimum follow-up of 14 months. Conclusion: This technique is an excellent option in cases of cerebrospinal fluid leaks in the tegmen tympani; it is easy to perform and results in minimum risk to patients.



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