Table 2.
Review of literature
| Author | Year | No. of cases | Etiology | Approach | Materials | F/U in months | Results in % | Comments |
|---|---|---|---|---|---|---|---|---|
| Adkins et al. | 1983 | 6 | COM 2, Iatrogenic 2, Congenital 1, Posttraumatic 1 | Combined | Autogenous graft | X | X | Minicraniotomy facilitates precise extradural, intracranial placement of graft over tegmen defect, avoiding morbidity and potential complications of full MCF approach |
| Golding-Wood et al. | 1991 | 4 | X | Subtemporal | Bone, Fascia | X | X | For surgical repair of tegmen defects with brain herniation, placing of bone enveloped by fascia via subtemporal approach is preferred |
| Lundy et al. | 1996 | 19 | Spontaneous 11, COM 4, Iatrogenic 2, Posttraumatic 2 | Combined 16, MCF 2, TM 1 | Bone, Fascia | 31 | 100 | Repair was accomplished in one stage in all cases by placing fascia-bone-fascia graft extradurally (multilayer technique) |
| Mosnier et al. | 2000 | 15 | COM 9, CH 5, Iatrogenic 1 | Combined 11, MCF 4 | Bone, Fascia | 24 | 100 | Extradural repair with fascia and bone using combined MCF-TM approach along with resection of the herniated part should be done in one or 2 stages, when necessary |
| Dutt et al. | 2001 | 4 | Spontaneous 4 | MCF | Autologous bone pate, fibrin glue, temporalis fascia | 12–36 | 100 | MCF approach is more effective than TM approach for tegmen defects with additional advantage of hearing preservation. Bone pate with soft tissue and glue achieve secure sealing of tegmen defects especially multiple without any risk of migration |
| Savva et al. | 2003 | 92 | X | X | Bone wax, free muscle, fascia, allogenic material(fibrin glue) | 24 | 100 in multilayer closure and 75.4 in single layer closure | No additional benefit of using fibrin glue with primary closure. Multilayer closure technique is recommended |
| Nahas et al. | 2008 | 15 | Spontaneous 15 | Combined | HAC, calvarial bone, fascia | X | 100 | Combined approach has advantage of optimal access to the tegmen defect. Repair of both dural and bony defects is necessary. HAC with bone grafting is helpful in filling small cortical defects |
| Sanna et al. | 2009 | 133 | Iatrogenic 45.9%, Spontaneous 24.8%, COM 21.8%, Posttraumatic 7.5% | TM 27.8%, MCF 27.8% Combined 3%, EO 41.4% | X | Mean 38.4 | X | Choice of approach must be based on the location and size of the herniated tissue, audiological status, concomitant pathology |
| Ota et al. | 2010 | 3 | Iatrogenic | TM | HAC, fat, fibrin glue | X | 100 | HAC (using multilayer technique) is effective biomaterial for repair of refractory CSF leak due to opening of air cells in deeper surgical fields |
COM chronic otitis media, TM transmastoid, MCF middle cranial fossa, HAC hydroxy appetite cement, MEO middle ear obliteration with blind sac closure of the external auditory canal, CH cholesteatoma