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Postoperative cerebrospinal fluid leak has occurred in sufficient magnitude to require secondary surgical closure in five cases (cases 8, 25, 50, 51, and 53). In several other cases there has been minor spinal fluid leak for several days postoperatively but spontaneous resolution has occurred. One of the major considerations when planning middle fossa and translabyrinthine approaches to the cerebellopontine angle was whether or not postoperative cerebrospinal leak would be a problem. It was determined during the cadaver dissections before these operations were attempted that it was not feasible to close the dura with sutures because of its thinness in the internal auditory canal and the difficulty in manipulating suture needles in the confined subtemporal area.
Experience with the middle fossa approach to the internal auditory canal had led us to the conclusion that covering the internal auditory canal with Gelfoam usually resulted in adequate closure so that a cerebrospinal fluid
HOUSE WF, HITSELBERGER WE. Postoperative Cerebrospinal Fluid Leak. Arch Otolaryngol. 1964;80(6):749–750. doi:10.1001/archotol.1964.00750040765019
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