Tegmen tympani cerebrospinal fluid leak epair

Abstract

ObjectiveTo describe the transmastoid approach for closing cerebrospinal fluid leaks in the tegmen tympani usingautologous materials (temporal muscle fascia and abdominal fat) and heterologous materials (bovine collagen), together withits advantages and disadvantages.Material and MethodsWe present the cases of three patients who underwent closure of spontaneous cerebrospinal fluidleaks in the tegmen tympani in which we used the transmastoid approach and autologous and heterologous materials. Thethree 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. Closure was performed using temporalmuscle fascia, abdominal fat and bovine collagen, fixed in place with fibrin glue. A lumbar shunt was established, as isroutine.ResultsThe cerebrospinal fluid leak was closed in all patients using the technique described, with a minimum follow-up of14 months.ConclusionThe technique presented herein is an excellent option in cases of cerebrospinal fluid leakage in the tegmentympani; it is easy to perform and results in minimal risk to patients.