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• W1496313182 abstract "Meningoencephalic herniation (MEH) in the middle ear and mastoid is a rare pathological entity with possible life-threatening complications. We treated 24 patients with a trans-mastoid approach, and the bony defect was closed by heterologous materials positioned in a multilayer fashion. The cause of the bony defect were chronic otitis media with cholesteatoma, iatrogenic, spontaneous and post-traumatic. The major presenting symptoms were meningitis, headache, conductive hearing loss, cerebrospinal fluid (CSF leak), neurologic deficit and pneumoencephalus, and stenosis of a canal wall down cavity. During follow-up, no patient developed complications due to surgery or related to the pathology, and imaging showed a stable occlusion of the bony defect. Different surgical treatments have been proposed to repair MEH, and the choice is based on the localization and size of the bony defect, preoperative auditory function and the presence of a coexisting pathology. We propose the use of collagenous membranes and bone substitutes for reconstruction of the floor of the middle fossa. Le ernie meningoencefaliche nell'orecchio medio e nella mastoide rappresentato una rara entità patologica con complicanze anche mortali. Abbiamo operato 24 pazienti con un approccio trans-mastoideo e abbiamo chiuso il difetto osseo utilizzando più strati di materiale eterologo. Nella nostra casistica il difetto osseo era stato causato nel 42% dei casi da un'otite cronica colesteatomatosa, nel 33% da causa iatrogena, nel 17% il difetto era spontaneo e infine nell'8% post-traumatico. I principali sintomi sono stati: meningite, cefalea, ipoacusia trasmissiva, fistola liquorale, deficit neurologici e pneumoencefalo, stenosi di cavità di timpanoplastica aperta. Durante il follow up nessun paziente ha presentato complicanze legate alla chirurgia o correlate alla patologia e le indagini radiologiche hanno evidenziato una stabile chiusura del difetto osseo. Numerose tecniche chirurgiche sono state proposte per la risoluzione di questa patologia e la scelta si basa sulla localizzazione e la grandezza del difetto osseo, la funzione uditiva e la presenza di patologie concomitanti. Riteniamo pertanto che la tecnica da noi proposta, che si basa sull'utilizzo di una membrana di collagene e di un sostituto osseo, possa essere adatta per la riparazione del pavimento della fossa cranica media e per la risoluzione di questa patologia." @default.
• W1496313182 created "2016-06-24" @default.
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• W1496313182 date "2013-04-01" @default.
• W1496313182 modified "2023-10-02" @default.
• W1496313182 title "Transmastoid approach to repair meningoencephalic herniation in the middle ear." @default.
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