![]() CONCLUSIONS Preoperative assessment of petrous pneumatization types is necessary to prevent CSF leaks. Tracts that directly connected to the antrum from the squamous part of the temporal bone and petrous apex, rather than through numerous air cells, were significantly related to CSF leak and were defined as "direct tract." All patients with a refractory CSF leak possessed "unusual tracts" that connected to the attic, tympanic cavity, or eustachian tube, rather than through the mastoid antrum. RESULTS The existence of air cells at the petrous apex, as well as fluid collection in the mastoid antrum detected by a postoperative CT scan, were possible risk factors for CSF leakage. METHODS Preoperative and postoperative target imaging of the temporal bone was performed in a total of 117 patients who underwent ATPA, and various surgery-related parameters were analyzed. In addition, other pre- and postoperative risk factors for CSF leakage after ATPA are discussed. In this study, some varieties of air cell tracts that are strongly related to CSF leaks are demonstrated. Although some complications associated with this approach, such as venous hemorrhage in the temporal lobe and nervous disturbances, have been resolved over the years, the incidence rate of CSF leaks has not greatly improved. OBJECTIVE The anterior transpetrosal approach (ATPA) was established in 1984 and has been particularly effective for petroclival tumors. Tamura, Ryota Tomio, Ryosuke Mohammad, Farrag Toda, Masahiro Yoshida, Kazunari Analysis of various tracts of mastoid air cells related to CSF leak after the anterior transpetrosal approach. ![]()
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