abstract nr.: O148

CHONDRO-MYO-FASCIAL FLAP (CHITRADURGA FLAP) FOR CLOSURE OF CEREBROSPINAL FLUID OTORRHOEA

Author: N.B. Prahlada, Karnataka ENT Institute & Research Centr, Chitradurga, India
Co-author(s): P.P. Devan, Kasturba Medical College, Mangalore, India
Topic: Surgery
Keywords: Transmastoid approach, CSF Otorrhoea, Chondro-myo-fascial flap, Brain Herniation
 
OBJECTIVES : Tegmen plate defects causing cerebrospinal fluid (CSF) leaks and brain hernias have conventionally been repaired using soft tissue grafts by a transmastoid approach. A review of the literature reveals that the results of transmastoid repairs have been less than satisfactory. We have developed a chondro-myo-fascial flap to overcome these failures. Hereby we present 11 patients with various causes of CSF otorrhoea who had tegmen or posterior fossa dural plate defects repaired using the chondro-myo-fascial flap.


METHODS : In this Randomized Prospective Study a post-aural, superiorly or posteriorly based chondro-may-fascial flap was developed to close the tegmen plate defect due to various causes.


RESULTS : Follow-up range was 1-4 years and 10 of 11 patients had uneventful postoperative periods and have had no subsequent CSF leak. This approach was associated with minimal mortality and morbidity.

CONCLUSION : We believe that the transmastoid approach still has value in the repair of CSF leaks and brain hernias through the tegmen and posterior fossa dural plate plate defects. Hearing is not significantly compromised with this approach. This approach is flexible and can be used for repair of CSF leak from tegmen tympani, tegmen mastoidea or posterior fossa dura. This approach is associated with minimal mortality and morbidity.


 
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