Usefulness of Transcranial Repair for Intractable Intracranial Infection Causedby Petrous Bone Defect

Abstract

Cerebrospinal fluid leaks via petrosal bone defects are uncommon but are an important cause of intractable intracranial infection. These defects are commonly associated with temporal bone trauma and lateral skull base andmastoid surgery but may also occur with tumors, radiotherapy, otitis media, congenital malformations, or spontaneous leaks. Regardless of the cause, the defects provide a route for the spread of infection in some cases, sopatients may present with potentially recurrent episodes of meningitis and fatal intracranial infection. Definitivediagnosis of the location of the fistula and surgical repair are recommended, but available imaging methods maynot localize the source. However, such defects may lead to leakage, so determination of the location and repair arenecessary. We describe the effective surgical repair technique based on our experience, which resulted in favorableoutcomes using the transcranial surgical approach.