Kronik otit veya cerrahisi sonrasında oluşan dural kemik defektleri ve ensefalosel
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Dosyalar
Tarih
2002
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kulak Burun Boğaz İhtisas Dergisi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Öz: Amaç: Radikal mastoidektomi veya açık kavite timpanoplasti yapılan olgularda dural kemik defekti ve ensefalosel sıklığı araştırıldı. Hastalar ve Yöntemler: Çalışmada 182 olguda (97 erkek, 85 kadın; ort. yaş 30.6; dağılım 9-70) yapılan 190 açık kavite (n=101) veya radikal mastoidektomi (n=89) ameliyatında dural kemik defekti ve ensefalosel gelişimi retrospektif olarak araştırıldı. Kontrollerde olguların otomikroskobik muayeneleri yapıldı. Ameliyat notunda veya muayenede dural kemik defekti saptanan olgularda temporal kemiğin aksiyel ve koronal planda bilgisayarlı tomografi incelemesi yapıldı. Ensefaloselden şüphelenilen olgularda ek olarak manyetik rezonans görüntülemeye başvuruldu. Bulgular: Ameliyat sırasında 17 olguda dural kemik defekti saptandı; 14 olguda defektin kronik otite bağlı oluştuğu belirlendi. Lateral sinüs tromboflebiti nedeniyle ameliyat edilen üç olguda posterior fossada kemik defekti iyatrojenik olarak oluşmuştu. Defekt, en sık mastoid teğmende (%41) bulundu. En yüksek oranda (%84) karşılaşılan etyolojik neden kolesteatom idi. Lateral sinüs tromboflebiti nedeniyle radikal mastoidektomi ve lateral sinüs obliterasyonu yapılan bir olguda ensefalosel saptandı. İki olguda defekte komşu alanda ensefalomalazi belirlendi. Sonuç: Kronik otit nedeniyle gelişen dural kemik defekti seyrek değildir ve en sık görülen neden kolesteatomdur. Ensefalosel gelişimini önlemek için dura laserasyonları su geçirmez sıkılıkta tamir edilmelidir.
Abstract: Objectives: We investigated the incidence of dural bone defects and encephalocele following radical mastoidectomy or open cavity tympanoplasty. Patients and Methods: We retrospectively evaluated 190 operations of 182 patients (97 males, 85 females; mean age 30.6 years; range 9-70 years) who underwent radical mastoidectomy (n=89) or open cavity tympanoplasty (n=101). Follow-up examinations included otomicroscopy. Patients with documented dural bone defects on examination or operation records were further evaluated by axial and coronal computed tomography scans of the temporal bone. Those with suspected encephalocele were studied by magnetic resonance imaging. Results: Dural bone defects were detected in 17 patients perioperatively. Of these, 14 defects were associated with chronic otitis media. Three iatrogenic bone defects were induced dur-ing obliteration of lateral sinus thrombosis. The mastoid tegmen was the most common site of defects (41%) and the most common etiologic factor was cholesteatoma (84%). Encephalocele was detected in one patient in whom radical mastoidectomy with lateral sinus obliteration was performed due to lateral sinus thrombophlebitis. Encephalomalasia was found nearby the defect area in two patients. Conclusion: Dural bone defects associated with chronic otitis media are not rare, the most common cause being cholesteatoma. Repair of dural lacerations requires watertight closure to prevent the occurrence of encephalocele.
Abstract: Objectives: We investigated the incidence of dural bone defects and encephalocele following radical mastoidectomy or open cavity tympanoplasty. Patients and Methods: We retrospectively evaluated 190 operations of 182 patients (97 males, 85 females; mean age 30.6 years; range 9-70 years) who underwent radical mastoidectomy (n=89) or open cavity tympanoplasty (n=101). Follow-up examinations included otomicroscopy. Patients with documented dural bone defects on examination or operation records were further evaluated by axial and coronal computed tomography scans of the temporal bone. Those with suspected encephalocele were studied by magnetic resonance imaging. Results: Dural bone defects were detected in 17 patients perioperatively. Of these, 14 defects were associated with chronic otitis media. Three iatrogenic bone defects were induced dur-ing obliteration of lateral sinus thrombosis. The mastoid tegmen was the most common site of defects (41%) and the most common etiologic factor was cholesteatoma (84%). Encephalocele was detected in one patient in whom radical mastoidectomy with lateral sinus obliteration was performed due to lateral sinus thrombophlebitis. Encephalomalasia was found nearby the defect area in two patients. Conclusion: Dural bone defects associated with chronic otitis media are not rare, the most common cause being cholesteatoma. Repair of dural lacerations requires watertight closure to prevent the occurrence of encephalocele.
Açıklama
Yıl: 2002Cilt: 9Sayı: 6ISSN: 1300-7475Sayfa Aralığı: 403 - 409Metin Dili:Türkçe
Anahtar Kelimeler
Kaynak
Kulak Burun Boğaz İhtisas Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
9
Sayı
6
Künye
KIZILAY A,ALADAĞ İ,ÇOKKESER Y,ÖZTURAN O (2002). Kronik otit veya cerrahisi sonrasında oluşan dural kemik defektleri ve ensefalosel. Kulak Burun Boğaz İhtisas Dergisi, 9(6), 403 - 409.
