![]() ![]() 001) in the petrous bones of the affected sides than in the contralateral healthy sides. The diameter of the internal auditory canal was significantly larger (P <. Thin-slice computed tomography was performed before and after surgery and assessed topographic measurements on both the pathological and healthy sides. One hundred patients operated on for vestibular schwannoma were included in a prospective study. The surgical technique and operative nuances are described Our results demonstrate that autologous fat grafts provide a safe and effective method of IAC defect closure to prevent postoperative CSF leakage after acoustic tumor removal via a retrosigmoid transmeatal approach. There were no instances of postoperative CSF leak (incisional leak, rhinorrhea, or otorrhea), pseudomeningocele formation, or occurrence of meningitis. No lumbar drains were used postoperatively. Twenty-four patients (10 males, 14 females) with a mean age of 47years (range 18-84) underwent fat graft-assisted IAC closure. They assessed rates of postoperative CSF leak (incisional leak, rhinorrhea, or otorrhea), pseudomeningocele formation, and occurrence of meningitis. They performed a retrospective study of 24 consecutive patients who underwent retrosigmoid transmeatal resection who underwent our method of fat graft-assisted IAC closure. describe a method of IAC closure using autologous fat graft and assessed the rates of postoperative cerebrospinal fluid leakage. The internal auditory canal IAC can be open with a high-speed diamond drill from lateral to medial, opening the canal for 180° of its circumferenceĭrilling into the petrous bone of the IAC can expose petrous air cells, which can potentially result in a fistulous tract to the nasopharynx manifesting as cerebrospinal fluid rhinorrhea.Īzar et al. Look for the safe zone of posterior semicircular canal resection in suboccipital retrosigmoid sinus approach for acoustic neuroma surgery The maneuver of transmeatal drilling carries the risk of injuring inner ear structures, which may cause immediate or delayed hearing loss.Ī complete drilling of the posterior wall of internal auditory canal ACis feasible and allows direct visualization of the internal auditory canal IAC-fundus without damaging the semicircular canals
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