SPONTANEOUS CEREBROSPINAL-FLUID LEAKS IN CONGENITAL AND ACQUIRED TEMPORAL BONE DEFECTS - A LONG-TERM FOLLOW-UP

Twelve patients presenting with tegmen defects and requiring surgical repair were retrospectively reviewed from 1982 to 1993. One half of th e patients presented with a cerebrospinal fluid leak at some time in t he course of their illness. Nine cases were considered to be acquired, secondary to previous mastoid surgery or trauma. All 9 had encephaloc oeles. Three spontaneous leaks were considered congenital; 2 of these patients had encephalocoeles. This report represents a long-term follo w-up of these cases. with an average follow-up of 7.6 years. Computed tomography and magnetic resonance imaging technology, as well as contr ast studies, have tremendously aided in diagnosis and planning of surg ical repair. Nine repairs were done through a dual transmastoid and mi ddle fossa approach, with the other 3 done via a transmastoid approach only. We favored temporalis muscle flaps and temporalis fascia over s ynthetic materials for defect repairs. The long-term results and compl ications are discussed.