Our Experience in the Management of CSF Otorrhea: A Transmastoid Approach with Middle Ear Cavity Obliteration and a Middle Cranial Fossa Approach

Özet

In this report, we present two cases of patients with cerebrospinal fluid (CSF) otorrhea who underwent surgical repair through eithera transmastoid or middle cranial fossa approach. In our first case, a 34-year-old male after head trauma with conductive hearingloss and a House-Brackmann grade 2 facial palsy was found to have a soft tissue mass protruding through his right tympanicmembrane. Radiological examination revealed a wide tegmen tympani defect. He underwent surgery via a transmastoid approachwith repair of the defect and blind sac closure of the external auditory canal after middle ear cavity obliteration. Our second caseinvolved a 50-year-old female who had developed chronic clear otorrhea following tympanostomy tube placement. Radiologicalevaluation revealed a tegmen tympani defect and CSF fistula. She underwent a middle cranial fossa approach in which a multilayerclosure technique was performed. These two cases illustrate that the type of surgical approach for the CSF otorrhea repair dependson the location and size of the defect and hearing status. We recommend a multilayer closure to ensure proper resolution of thedefect.