Altamura C.F ,D'Angelo L ,Francesco Paglia,Marzetti F ,Sampirisi L ,Santoro A ,
Management of Spontaneous Cerebrospinal Fluid Leaks in the Middle Cranial Fossa and Bone Tegmen Tympani Defect in Patients with Meningitis and Rhinorrhea
Surgical Case Reports
2020
2613-5965
http://dx.doi.org/10.31487/j.SCR.2020.02.09
https://www.sciencerepository.org/management-of-spontaneous-cerebrospinal-fluid_SCR-2020-2-109 
Abstract: The pathogenetic process of spontaneous CerebroSpinal Fluid (CSF) leaks in the middle cranial fossa has not been clearly identified yet. It is related to a tegmen defect associated to the presence of a simultaneous encephalocele or meningoencephalocele. The main complication of a CSF leak is meningitis, whose occurrence rate ranges from 4% to 50% according to different causes and conditions of the leak [1]. Surgical approaches to temporal bone reconstruction include middle cranial fossa (MCF) craniotomy, transmastoid (TM), or a combined (MCF/TM) approach. In our experience, we describe 2 cases of patients who presented with CSF rhinorrhea and meningoencephaloceles correlated with conductive hearing loss and meningitis. The MCF approach is a considerable way to successful repair CSF leaks and encephaloceles due to tegmen tympani and dural defects.Keywords: Spontaneous cerebrospinal fluid leaks, MRI, high resolution tomography scan, hydroxyapatite, middle cranial fossa, transmastoid