Upfront use of temporal myofascial flap for repair of traumatic injury and prevention of CSF leaks: illustrative cases.
Publication/Presentation Date
9-1-2025
Abstract
BACKGROUND: Traumatic brain injury involving destruction of the mastoid bone leading to a large defect in the middle fossa floor or posterior fossa dura can necessitate delayed or multistep repairs or reconstruction of the middle fossa floor because of a CSF leak and rhinorrhea. Delayed repair may be associated with CNS infection. Reconstruction using a temporalis myofascial flap has been described in delayed reconstruction cases with CSF leak. The authors report a novel concept of upfront repair.
OBSERVATIONS: Two patients with gunshot wound injuries involving the mastoid and middle fossa floor or posterior fossa dura underwent decompression and simultaneous early reconstruction with a temporalis myofascial flap sutured to the middle fossa dura. Both patients avoided prolonged CSF leak and had no complications from this approach.
LESSONS: Upfront repair of traumatic defects of the middle fossa floor or posterior fossa dura involving the mastoid air cells may avoid a prolonged CSF leak and its complications. https://thejns.org/doi/10.3171/CASE25412.
Volume
10
Issue
9
ISSN
2694-1902
Published In/Presented At
Rao, A. N., Ricci, S. L., Pathak, S., Hannah, T., Ziechmann, R., & Villanueva, P. (2025). Upfront use of temporal myofascial flap for repair of traumatic injury and prevention of CSF leaks: illustrative cases. Journal of neurosurgery. Case lessons, 10(9), CASE25412. https://doi.org/10.3171/CASE25412
Disciplines
Medicine and Health Sciences
PubMedID
40889409
Department(s)
Fellows and Residents
Document Type
Article