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June 1969

Surgical Repair of Dural Herniation Into the Mastoid Bowl

Author Affiliations

From the Department of Neurosurgery (Dr. Trowbridge), and the Department of Otolaryngology (Drs. Stout and Ruggles), St. Luke's Hospital, Cleveland.

Arch Otolaryngol. 1969;89(6):850-855. doi:10.1001/archotol.1969.00770020852010

The PURPOSE of this paper is to present a new surgical technique for the correction of herniated dura into the mastoid bowl and external canal.

Review of Literature  In 1727, Vander Weil reported the first case of watery fluid escaping from an ear following head trauma.1 This was at a time when the existence of cerebrospinal fluid was not known. In 1899, the spontaneous discharge of cerebrospinal fluid from the nose was first positively established as a pathological possibility by St. Clair Thomson.2 The first reported surgical repair of a post-operative dural fistula was by Canfield in 1913.3 He reported four cases, one of which followed a labyrinthectomy. The fistula closed and the otorrhea ceased following suturing of the dural defect and tamponing a piece of dog's dura over the defect.Dandy reported the first successful treatment of rhinorrhea by fascial grafts in each of three cases.

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