J Neurol Surg B Skull Base
DOI: 10.1055/a-2430-0394
Original Article

Surgical Technique for Repair of Tegmen Dehiscence with Encephalocele: A Retrospective Study

Marcelle Altshuler
1   Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Rohan Jha
2   Harvard Medical School, Boston, Massachusetts, United States
,
Saksham Gupta
1   Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Christopher S. Hong
1   Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Kaasinath Balagurunath
3   Boston University, Boston, Massachusetts, United States
,
Jakob V.E. Gerstl
1   Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Yohan Song
4   Department of Otolaryngology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Eduardo Corrales
4   Department of Otolaryngology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Timothy Smith
1   Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
› Institutsangaben
Preview

Abstract

Background and Objectives Tegmen dehiscence with encephalocele presents certain surgical challenges, necessitating innovative approaches to improve patient outcomes and minimize complications. Here we aim to evaluate the safety and efficacy of a novel middle cranial fossa craniotomy technique.

Methods Nineteen adult patients with radiographically confirmed tegmen dehiscence with encephalocele were included. Patients underwent a middle cranial fossa craniotomy technique for tegmen dehiscence repair, utilizing a split-thickness bone graft, pedicled pericranial flap, and hydroxyapatite for extradural repair and with an inlay graft for the intradural repair. The primary outcome measured was the major perioperative complications or need for revision surgery, while the secondary outcome measured was the resolution or improvement of preoperative symptoms associated with tegmen dehiscence.

Results Our series encompassed tegmen dehiscence repairs in 19 patients, with an average age at surgery of 51 years (range: 24–82 years). The average follow-up time was 8.80 months (range: 0.43–27.62 months). Patients commonly presented with symptoms such as hearing loss (n = 8), otorrhea (n = 8), fullness or ear pressure (n = 6), dizziness or imbalance (n = 6), or a history of meningitis (n = 4), among others. Postoperatively, symptoms resolved completely in 42% of patients (n = 8) and partially in 58% of patients (n = 11). Notably, no patients required revision surgery or developed new dehiscence in the follow-up period.

Conclusion Our middle cranial fossa craniotomy technique for tegmen dehiscence with encephalocele repair demonstrated promising postoperative outcomes, with complete or partial symptom resolution in all patients and no major complications. Our findings suggest that this technique is a safe and effective approach for tegmen dehiscence repair.



Publikationsverlauf

Eingereicht: 30. Juni 2024

Angenommen: 27. September 2024

Accepted Manuscript online:
01. Oktober 2024

Artikel online veröffentlicht:
22. Oktober 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany