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June 1968

Cerebrospinal Fluid Otorrhea: A Method of Closure

Author Affiliations

From the Pittsburgh Otological Association, Pittsburgh.

Arch Otolaryngol. 1968;87(6):588-589. doi:10.1001/archotol.1968.00760060590006

CEREBROSPINAL fluid (CSF) otorrhea may result following the translabyrinthine removal of acoustic neuroma, fracture of the temporal bone, and rarely occurs spontaneously. The CSF leak per se is not a serious complication, but the constant impending threat of meningitis necessitates adequate control of such leaks.

The control of cerebrospinal fluid otorrhea has not been uniformly successful with the various techniques previously described. Following the translabyrinthine removal of acoustic neuroma, House1 used free temporalis muscle grafts with a resultant 10% incidence of persistent postoperative CSF leak. Free temporalis fascia grafts held in place with a tissue adhesive (Monomer-2-cyanoacrylate) resulted in one leak in 13 successive cases.2 This method, however, is technically difficult; and, also, the tissue adhesive is available only for research use.

This paper presents a technique utilizing a subcutaneous fibro-fascial periosteal-attached pedicle flap to close the dural defect.3-5

Technique  A curvilinear incision is made approximately 1

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