Yoshikazu Kyuma

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.

Selection of Shunt Systems and Improvement of Techniques on Shunt Operations of Hydrocephalic Children

We have had experience with 50 children with nontumoral hydrocephalus treated with shunting (mainly ventriculoperitoneal shunts) over a period of 12 years and have followed them up for at least one year. They were divided into two groups: A and B, consisting of 30 and 20 cases respectively. In Group A, all the shunt operations were done in our own hospital (KRC). In contrast, in Group B, revisions were done in KRC after the initial shunt operation and several revisions had been performed in other hospitals.