Vascularized temporalis muscle flap for the treatment of XXXX . Technical note.

@entity1 @entity410 @entity1276 @entity428 @entity75 @entity2972 @entity693 @entity79 @entity121
The surgical treatment for cerebral spinal fluid (CSF) fistulas provides closure of the bone and dural defects and prevents the recurrence of @entity75 . The two main approaches used are the transmastoid and middle fossa ones. The authors review the results of performing a modified middle fossa approach with a vascularized temporalis muscle flap to create a barrier between the repaired dural and @entity79 . Fifteen consecutive cases of CSF fistulas treated at the authors' institution were retrospectively reviewed. All @entity1 presented with @entity2972 . Eleven @entity1 had previously undergone ear surgery. A middle fossa approach was followed in all cases. The authors used a thin but watertight and vascularly preserved temporalis muscle flap that had been dissected from the medial side of the temporalis muscle and was laid intracranially on the floor of the middle fossa, between the repaired dura mater and petrous bone. The median follow-up period was 2.5 years. None of the @entity1 experienced recurrence of @entity2972 or @entity693 . There was no complication related to the intracranial temporalis muscle flap (for example, @entity410 or @entity428 caused by @entity121 ). One @entity1 developed @entity1276 , which resolved after the placement of a ventriculoperitoneal shunt 2 months later. The thin, vascularized muscle flap created an excellent barrier against the recurrence of CSF fistulas and also avoided the risk of @entity428 caused by @entity121 . This technique is particularly useful in refractory cases.
