Repair of Temporal Bone Encephalocele following Canal Wall Down Mastoidectomy
Figure 3
(a) Preparation for the semilunar skin incision immediately over the right ear. (b) Encephalocele: dural gap (blue arrow) and protruding brain (white arrows). (c) Bony deficit of elliptical shape with abnormal borders on the roof of the right external auditory meatus (blue borderline, prior to removal of the protruding brain from its cavity). (d, e) Cauterization and resection of the encephalocele (blue arrows). (f) Bony deficit after removal of the protruding brain from its cavity (blue borderline). (g) Extracranial reconstruction of the bony deficit with use of the temporalis fascia graft and glue. (h) Intracranial reconstruction of the bony deficit with the nasal cartilage. (i) Dural gap extradural view (blue arrow: dural gap, white arrow: artificial dura graft). (j) Artificial dural graft was used to cover the dural gap extradurally (in touch on one side with the dura and on the other with the cartilage) (blue arrow: nasal cartilage, white arrow: artificial dura graft). (k) Dural gap intracranial view (blue arrow). (l) Artificial dura graft to cover dural gap intracranial view (blue arrows).
