Year: 2014
Type: article
Abstract: Skull base approaches requiring retro- or translabyrinthine petrosectomy are frequently used for vestibular schwannoma and cerebellopontine angle tumor removal. One postoperative challenge is pseudomeningocele formation. Primary dural closure is often impractical due to dural shrinkage from cautery, desiccation, and the fact that pre-sigmoid dura is difficult to approximate with the retro-/translabyrinthine approach. Synthetic, allograft, and autograft dural substitutes have been used with varying success rates. Pericranial autograft is a desirable substitute due to lack of immunogenicity, flexibility, and wide availability adjacent to posterior fossa lesions. Autologous fat has been used to pack the pre-sigmoid dural defect in order to effect a watertight seal. However, no method is completely effective. We present a technical note on use of a vascularized rotational pericranial flap technique for repair of refractory pseudomeningocele after translabyrinthine petrosectomy. In our experience, this technique, when combined with temporary or permanent CSF diversion, allows for definitive dural closure and repair of pseudomeningocele.
Source: Cureus
DOI: 10.7759/cureus.153
Language: Spanish
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2169518309