Universität zu Köln

Schwarz, David ORCID: 0000-0002-4580-8383, Gostian, Antoniu-Oreste, Shabli, Sami, Wolber, Philipp, Huettenbrink, Karl Bernd and Anagiotos, Andreas (2018). Analysis of the dura involvement in cholesteatoma surgery. Auris Nasus Larynx, 45 (1). S. 51 - 57. OXFORD: ELSEVIER SCI LTD. ISSN 1879-1476

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Abstract

Objective: The involvement of the dura is a rare yet potentially life-threatening complication during cholesteatoma surgery. Thus, the knowledge about treatment and consequences of this issue is of great importance to every ear surgeon. Methods: This retrospective study analyzed the dura involvement with regard to the type of defect, reconstruction method used, and the post-operative complications of 1291 pediatric and adult cholesteatoma surgeries performed at an academic tertiary care center over a twelve-year period. Results: From a total of 1291 cholesteatoma surgeries, we identified 84 patients (6.5%) with dura involvement intraoperatively, most of them adult patients. The majority of the reported cases were bony defects and exposed dura without CSF leakage (79.73%, 67 out of 84). In 14.28% of the cases (12 out of 84) a meningo(encephalo)cele or dura defect with liquorrhea were detected. In 30 surgeries (35.7%, 30 out of 84) no reconstruction of the lateral skull base was considered necessary. The most common material used for reconstruction was conchal cartilage (25.0%, 21 out of 84), followed by polydioxanone (PDS)-foil (11.9%. 10 out of 84), bone pate (9.5%, 8 out of 84) and a combination of materials (17.9%, 15 out of 84). Revision surgery of the reconstruction was necessary in 16.7% (14 out of 84) of the cases. Long-term evaluation (mean of 19.3 months) showed no complication related to the skull base defect. Conclusion: During cholesteatoma surgery, bony and dura defects can be managed effectively, with good long-term reliability. No intracranial or mastoidal complications are expected. (C) 2017 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schwarz, David UNSPECIFIED orcid.org/0000-0002-4580-8383 UNSPECIFIED Gostian, Antoniu-Oreste UNSPECIFIED UNSPECIFIED UNSPECIFIED Shabli, Sami UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolber, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Huettenbrink, Karl Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Anagiotos, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-197260
DOI:	10.1016/j.anl.2017.02.010
Journal or Publication Title:	Auris Nasus Larynx
Volume:	45
Number:	1
Page Range:	S. 51 - 57
Date:	2018
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1879-1476
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHRONIC OTITIS-MEDIA; INTRACRANIAL COMPLICATIONS; MANAGEMENT; WALL Multiple languages Otorhinolaryngology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19726