Section: 
Science articles
Science articlesA method of closure of the bone defect of the middle cranial fossa in the patients with cerebral hernia after the radical surgery of the middle ear
I. A. Anikin (1), N. N. Khamgushkeeva (1), S. S. Gaidukov (1)
(1) Federal State Budgetary Institution Saint Petersburg Research Institute of Ear, Throat, Nose and Speech of the Ministry of Healthcare of Russia, Saint Petersburg, Russia
UDK: 616.284-002.2-089.847
DOI: https://doi.org/10.18692/1810-4800-2018-5-9-13
ABSTRACT
The article describes a method for closing a bone defect in the middle cranial fossa, developed for patients with chronic suppurative otitis media complicated by the development of cerebral hernia and cholesteatoma, including the extended anthromastoidotomy to achieve the bone defect visualization, resection of the cerebral hernia with a bipolar coagulant, the closure of the bone defect both with a cartilaginous plate installed behind the edges of the bone defect intracranially or with a fascial flap, characterized by the fact that a hearing-improvement and open sanitizing operation is performed simultaneously with the closure of the bone defect. First, the closure of the bone defect is performed: a titanium plate-grid is placed between the cartilage plate and the fascial flap, it is put behind the anterior edge of the bone defect, and its posterior part is sutured to the hole formed at the side of the cortical surface of mastoid process; after that a cholesteatoma is removed from the affected temporal bone structures; plastic expansion of the external auditory canal is followed by tympanoplasty, and the anthromastoidal cavity in the postoperative period is managed in open condition. This method provides the patient’s hearing improvement, simultaneously reducing the risk of recurrence of cerebral hernia, residual cholesteatoma of the temporal bone. The results of the treatment were assessed using otomicroscopy, multislice spiral computed tomography of the temporal bone, MRI of the middle ear.
Publication date:
01.10.2018
Keywords:
cerebral hernia, cholesteatoma, chronic suppurative otitis media, middle cranial fossa defect. For citation:
Anikin I. A., Khamgushkeeva N. N., Gaidukov S. S. A method of closure of the bone defect of the middle cranial fossa in the patients with cerebral hernia after the radical surgery of the middle ear. Rossiiskaya otorinolaringologiya. 2018;5:9–13. https://doi.org/10.18692/1810-4800-2018-5-9-13