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Inicio Acta Otorrinolaringológica Española Combined Approach for the Treatment of Spontaneous Temporal Encephaloceles: Tran...
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Vol. 65. Issue 1.
Pages 43-46 (January - February 2014)
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Vol. 65. Issue 1.
Pages 43-46 (January - February 2014)
Brief communication
Combined Approach for the Treatment of Spontaneous Temporal Encephaloceles: Transmastoid Plus Temporal Minicraniotomy
Abordaje combinado para el tratamiento de los encefaloceles temporales espontáneos: mastoidectomía + minicraneotomía
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Julio Rama-López
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julioramalopez@hotmail.com

Corresponding author.
, Rosana Rodríguez-Villalba, Pedro Sarría-Echegaray, Manuel Tomás-Barberán
Servicio de Otorrinolaringología, Sección de Otoneurología, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, Spain
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Abstract

Spontaneous encephaloceles are defined as brain herniations with no apparent cause. The aim of this paper is to describe the surgical technique performed in our department.

We reviewed the last 3 cases treated with combined approach (transmastoid plus minicraniotomy) with 2-layer closure.

In all cases the bone defects were located and successfully sealed. We had no postoperative complications. There were no relapses in our follow-up period.

The transmastoid approach has the advantage over the open approach with middle fossa craniotomy in that it locates the bone defect with no brain retraction. Nevertheless, it is not useful in large-sized, multiple or anterior defects. Due to those drawbacks, we think that the combined approach with temporal minicraniotomy is the best choice for this entity.

Keywords:
Cerebrospinal fluid leak
Encephalocele
Minicraniotomy
Transmastoid
CSF otorrhea
Resumen

Los encefaloceles espontáneos son aquellos en los que no se puede determinar un origen. El objetivo del trabajo consiste en describir el tratamiento quirúrgico empleado.

Presentamos los 3 últimos casos tratados mediante abordaje combinado transmastoideo y minicraneotomía, y cierre con cartílago y pericondrio conchal.

En todos los casos se pudo acometer una correcta localización del encefalocele con un adecuado sellado del defecto óseo. No existieron complicaciones postoperatorias. No existieron recidivas en el periodo de seguimiento.

El abordaje transmastoideo tiene la ventaja de permitir la localización del defecto en la base del cráneo sin provocar morbilidad neurológica. Sin embargo, y sobre todo en defectos amplios o de localización más anterior no permite un correcto sellado del defecto óseo y/o un control de todo el volumen de tejido herniado. Debido a estas limitaciones creemos una buena indicación combinar el abordaje transmastoideo con la realización de una minicraneotomía temporal.

Palabras clave:
Fístula de líquido cefalorraquídeo
Encefalocele
Minicraneotomía
Mastoidectomía
Otolicuorrea

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