Skull base defects in the middle and posterior cranial fossa with unchanged mucous lining middle ear spaces
Journal Title: Otolaryngologia Polska - Year 2012, Vol 66, Issue 5
Abstract
Background: Skuli bone defects in the region of middle ear are usually observed in the cases of chronic otitis media. Such loses can also be congenital, posttraumatic, iatrogenic or due to hyperplasia. They can potentially lead to development of otogenic intracranial complica-tions. Aim: We present the patients who were not observed during otosurgery to have any pathological changes to the mucous of the middle ear and were diagnosed as having bone defects in the middle and/or posterior cranial fossa. We discuss also methods of recon-struction during otosurgery. Material and methods: The prospective analysis involves the patients operated on middle ear in the Department of Otolaryngology at the Jagiellonian University of Krakow in the years 2007-2011. 495 first-time otosurgeries were performed in this period of time. Results: Skuli bone defects were diagnosed in 46 patients who had undergone surgery and 25% of these patients had no changes to the middle ear mucous. This points to congenital etiology of the defects. In this group the most common cause for otosurgery was chronic otitis media (10 patients). In 1 patient, bone defect occurred along with otosclerosis. In patients with congenital skuli bone defects otogenic intracranial complications were described in 4 cases. Conclusions: Nearly 80% of skuli bone defects remain asymptomatic; they are revealed incidentally during the surgery of the middle ear. The above observations emphasize the significant role of preoperative imaging diagnostics. The methods of bone defects reconstruction using the fascia, strengthened with the pedicle muscle flap where larger defects occurred, as well as with either bone lamella or cartilage in particular cases, proved successful.<br/><br/>
Authors and Affiliations
Maciej Wiatr, Agnieszka Morawska, Jacek Składzień, Jerzy Tomik, Robert Przeklasa, Henryk Podziorny
Keywords
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