Cosmetic reconstruction after mastoidectomy for the transpetrosal-presigmoid approach: technical note.

[OBJECTIVE] We describe the technique of cosmetic reconstruction after mastoidectomy in the transpetrosal-presigmoid approach for petroclival lesions.

[TECHNIQUES] This technique involves raising a single temporo-occipital bone flap and cosmetic mastoidectomy, removing the mastoid bone fragments (by means of a rongeur instead of an air drill) for later reconstruction. Replacement of the bone fragments mixed with fibrin glue enables tamponade against the dura to be achieved without a fat graft.

[RESULTS] Computed tomographic scans and plain cranial films taken a few years later showed successful reconstruction of the mastoid bone with a good appearance of the retromastoid area in seven patients who underwent this procedure. The only complication was infection in one patient from cerebrospinal fluid leakage from the wound.

[CONCLUSION] We have developed a simple and easy technique of cosmetic reconstruction after the transpetrosal-presigmoid approach.