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. 2021;36(3):249-256.
doi: 10.5222/MMJ.2021.96393. Epub 2021 Sep 30.

Postoperative Radiologic Assessment and Long-Term Clinical Results of Tegmen Mastoideum Defects

Murat Ozturk  1 , Deniz Ozlem Topdag  2 , Ahmet Mutlu  3 , Hakan Bayraktar  4 , Selvet Erdogan  5 , Mete Iseri  6
Affiliations

Postoperative Radiologic Assessment and Long-Term Clinical Results of Tegmen Mastoideum Defects

Murat Ozturk et al. Medeni Med J. 2021.

Abstract
in English, Turkish

Objective: Tegmen defects occur mainly due to cholesteatoma and iatrogenic trauma, and the intervention for the related defects is still a debate. In this study, we aimed to discuss our clinical experience on the management of the tegmen defects which were revealed during the mastoidectomy surgeries.

Methods: This study was designed as a retrospective chart review study and patients who were operated between 2007-2017 were included. The causes of the defects, repair technics, and results of the long-term follow up were evaluated. The perioperative and postoperative defect sizes which were obtained from the radiological studies were analyzed.

Results: Total number of 62 patients had tegmen defects, and their etiologic factors were cholesteatoma in 31 (50%), iatrogenic factors in 29 (46.7%), and chronic infection in 2 (3.3%) patients. The number of the tegmen defects was higher in intact canal wall technic. All of the tegmen defects were repaired with different materials, and no complication was detected. The obtained data from the postoperative radiological images revealed that the related perioperative defects were significantly decreased (p<0.001).

Conclusion: The perioperative bone defects were observedly decreased significantly in postoperative period. Early detection of the defect and appropriate interventions may help to manage this problem without any complication in the long term.

Amaç: Tegmen kusurları esas olarak kolesteatom ve iyatrojenik travmaya bağlı olarak ortaya çıkar ve ilgili kusurlara müdahale hala tartışma konusudur. Bu çalışmada mastoidektomi ameliyatları sırasında ortaya çıkan tegmen defektlerinin yönetimi ile ilgili klinik deneyimimizi tartışmayı amaçladık.

Yöntem: Bu çalışma retrospektif bir dosya inceleme çalışması olarak tasarlandı ve 2007-2017 yılları arasında ameliyat edilen hastalar dahil edildi. Defektin nedenleri, onarım teknikleri ve uzun süreli takip sonuçları değerlendirildi. Radyolojik çalışmalardan elde edilen perioperatif ve postoperatif defekt boyutları incelendi.

Bulgular: Toplam tegmen defekti olan hasta sayısı 62 olup defekt etiyolojisi sırasıyla 31’inde (%50) kolesteatom, 29’unda (%46,7) iyatrojenik ve 2’sinde (%3,3) kronik enfeksiyon olarak izlendi. İntakt kanal duvarı tekniğinde tegmen defekti sayısı daha fazlaydı. Tüm tegmen defektleri farklı materyallerle onarıldı ve herhangi bir komplikasyon tespit edilmedi. Postoperatif radyolojik görüntülerden elde edilen veriler, ilgili perioperatif defektlerin anlamlı olarak azaldığını ortaya koydu (p<0,001).

Sonuç: Postoperatif dönem takiplerinde perioperatif kemik defektlerinin önemli ölçüde azaldığı izlendi. Kusurun erken tespiti ve uygun müdahaleler bu sorunun uzun vadede herhangi bir komplikasyon olmaksızın yönetilmesine yardımcı olabilir.

Keywords: Chronic otitis media; cerebrospinal fluid leakage; encephalocel; mastoidectomy; tegmen tympani defects.

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Conflict of interest statement

Conflict of interest: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
The endoscopic view of the defect of two patients at physical examination with angled endoscopes in postoperative follow up period; (A) grafted with fascia, (B) grafted with cartilage.
Figure 2
Figure 2
(A) The postoperative bony defect of a patient whose defect was repaired with fascia; Sagittal CT image. (B) The postoperative bony defect of another patient whose defect was repaired with bone and fascia; Sagittal CT image. The graft can be see.
See this image and copyright information in PMC

References

    1. Kizilay A, Aladag I, Cokkeser Y, Ozturan O. Dural bone defects and encephalocele associated with chronic otitis media or its surgery. Kulak Burun Bogaz Ihtis Derg. 2002;9:403–9. PMID: 12499827. - PubMed
    1. Egilmez OK, Hanege FM, Kalcioglu MT, Kaner T, Kokten N. Tegmen tympani defect and brain herniation secondary to mastoid surgery: case presentation. Case Rep Otolaryngol. 2014;2014:756280. [CrossRef] - PMC - PubMed
    1. Stevens SM, Rizk HG, Golnik K et al. Idiopathic intracranial hypertension: Contemporary review and implications for the otolaryngologist. Laryngoscope. 2018;128:248–56. [CrossRef] - PubMed
    1. Genc S, Genc MG, Arslan IB, Selcuk A. Location of the middle cranial fossa dural plate in patients with chronic otitis media. J Laryngol Otol. 2014;128:60–3. [CrossRef] - PubMed
    1. Markou K, Goudakos J, Franco-Vidal V, Vergnolles V, Vignes JR, Darrouzet V. Spontaneous osteodural defects of the temporal bone: diagnosis and management of 12 cases. Am J Otolaryngol. 2011;32:135–40. [CrossRef] - PubMed

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