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Comparison of Outcomes of Surgical Repair of Spontaneous Temporal Bone CSF Leaks and Encephaloceles Using Bone Cement and Autologous Material.

Publication ,  Journal Article
Hwa, TP; Patel, V; Eliades, SJ; Brant, JA; Bigelow, DC; Ruckenstein, MJ
Published in: Otol Neurotol
April 1, 2022

OBJECTIVE: To compare outcomes transmastoid repair of spontaneous middle fossa cerebrospinal fluid (CSF) leak using only bone cement (BC) versus only autologous material (AM) or combined materials (CM) with both bone cement and autologous material. STUDY DESIGN: Retrospective Chart Review. SETTING: Tertiary Care Hospital. PATIENTS: Forty-three adult patients undergoing transmastoid repair of spontaneous middle fossa CSF leak between 2014 and 2020 (BC:12, AM:15, CR:16). INTERVENTIONS: Cortical mastoidectomy, identification of defect, and repair with BC (Cranios® hydroxyapatite), AM (local bone, fascia, fat, and/or cartilage), or CM (Cranios® combined with autologous materials). MAIN OUTCOME MEASURES: Successful repair without recurrent CSF leak or encephalocele throughout follow up. RESULTS: Fifty-one percent of subjects were female. Mean age at repair was 58.6 years (SD 10.9). Mean BMI was 35.4 (SD 7.6; BC:36.3, AM:36.5, CM:33.6). Forty (93%) patients had successful repair without known recurrent CSF leak or encephalocele since surgery (BC:11, 91.6%; AM:14, 93.3%; CM:15, 93.8%; p = 0.49) over a mean length of follow up of 49.6 months (BC: 37.9, AM: 59.2, CR: 49.5). The difference in mean operative time amongst the groups was faster for patients using bone cement (BC: 100.2 min, AM: 182.8, CM: 133.2; p < 0.00001). CONCLUSIONS: BC, AM, and CM techniques each demonstrate effective and sustained means of repair for middle fossa CSF leak and encephalocele, even in the presence of multiple defects. Use of isolated BC offers a significant decrease in operative time with a noninferior outcome. Active CSF leak at the time of surgery is associated with increased risk of recurrence.

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Published In

Otol Neurotol

DOI

EISSN

1537-4505

Publication Date

April 1, 2022

Volume

43

Issue

4

Start / End Page

500 / 505

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Temporal Bone
  • Retrospective Studies
  • Otorhinolaryngology
  • Male
  • Humans
  • Female
  • Encephalocele
  • Cerebrospinal Fluid Leak
  • Bone Cements
 

Citation

APA
Chicago
ICMJE
MLA
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Hwa, T. P., Patel, V., Eliades, S. J., Brant, J. A., Bigelow, D. C., & Ruckenstein, M. J. (2022). Comparison of Outcomes of Surgical Repair of Spontaneous Temporal Bone CSF Leaks and Encephaloceles Using Bone Cement and Autologous Material. Otol Neurotol, 43(4), 500–505. https://doi.org/10.1097/MAO.0000000000003467
Hwa, Tiffany Peng, Vir Patel, Steven J. Eliades, Jason A. Brant, Douglas C. Bigelow, and Michael J. Ruckenstein. “Comparison of Outcomes of Surgical Repair of Spontaneous Temporal Bone CSF Leaks and Encephaloceles Using Bone Cement and Autologous Material.Otol Neurotol 43, no. 4 (April 1, 2022): 500–505. https://doi.org/10.1097/MAO.0000000000003467.
Hwa TP, Patel V, Eliades SJ, Brant JA, Bigelow DC, Ruckenstein MJ. Comparison of Outcomes of Surgical Repair of Spontaneous Temporal Bone CSF Leaks and Encephaloceles Using Bone Cement and Autologous Material. Otol Neurotol. 2022 Apr 1;43(4):500–5.
Hwa, Tiffany Peng, et al. “Comparison of Outcomes of Surgical Repair of Spontaneous Temporal Bone CSF Leaks and Encephaloceles Using Bone Cement and Autologous Material.Otol Neurotol, vol. 43, no. 4, Apr. 2022, pp. 500–05. Pubmed, doi:10.1097/MAO.0000000000003467.
Hwa TP, Patel V, Eliades SJ, Brant JA, Bigelow DC, Ruckenstein MJ. Comparison of Outcomes of Surgical Repair of Spontaneous Temporal Bone CSF Leaks and Encephaloceles Using Bone Cement and Autologous Material. Otol Neurotol. 2022 Apr 1;43(4):500–505.

Published In

Otol Neurotol

DOI

EISSN

1537-4505

Publication Date

April 1, 2022

Volume

43

Issue

4

Start / End Page

500 / 505

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Temporal Bone
  • Retrospective Studies
  • Otorhinolaryngology
  • Male
  • Humans
  • Female
  • Encephalocele
  • Cerebrospinal Fluid Leak
  • Bone Cements