Cerebrospinal fluid (CSF) leaks often follow traumatic or iatrogenic injuries of the temporal bone. Surgical management to seal the leak usually involves either mastoidectomy or craniotomy.
When permanent hearing loss accompanies a temporal bone injury with CSF leakage, the eustachian tube can be sealed by obliterating the middle ear with muscle through a tympanotomy under local anesthesia. No attempt is made to seal the bony dural defect, since the pharynx no longer communicates with the subarachnoid space. This operation recently has been performed successfully in two patients.
Calcaterra TC, Rand RW. Tympanic Cavity Obliteration for Cerebrospinal Otorhinorrhea. Arch Otolaryngol. 1973;97(5):388–390. doi:10.1001/archotol.1973.00780010400007
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