Repair of Temporal Bone Defects with Bone Cement: Our Experience

Abstract

Objective: The defects of temporal bone are classified according to their causative factor. Definitive repair of the defect is paramount to prevent potentially devastating complications. There are different approaches, and multiple materials have been used to repair the defects. We describe our experience using bone cement.

Method: Medical records of consecutive patients with spontaneous defect of the temporal bone were reviewed. A retrospective review was performed over a 5-year period. Clinical presentation, diagnosis process, intraoperative findings, operative technique, and postoperative follow-up. The surgical technique was reviewed as well as the wound healing and structural integrity results.

Results: Five of the 7 patients were women (4 spontaneous cerebrospinal fluid otorrhea, 1 colesterine granuloma, and 2 after mastoidectomy). Ages ranged from 42 to 63 years. Four patients presented with meningitis. The location and the extent of the defect were detected by computed tomography in all cases. The most common defect sites were located over the tegmen mastoideum and tegmen tympany. All the tegmen defects were repaired using a middle fossa approach with bone cement. All patients had complete resolution of the problem without adverse effects.

Conclusion: Surgical management using a middle fossa craniotomy is outlined. The bone cement is hard within minutes of application. This procedure offers a simple and reliable method for repairing the tegmen defects with a high cure rate.