Middle Fossa Approach to Repair Cerebrospinal Fluid Leak

1. Introduction

2. Incision and Exposure

1. Temporalis Fascia Graft Harvest
2. Exposure of Temporal Bone

3. Middle Fossa Craniotomy

4. Dura Elevation

1. Identification and Exposure of Tegmen Defect

5. Repair of Tegmen Defect

1. Measure Defect
2. Harvest Bone Graft
3. Shaping Bone Graft
4. Prepare the Fascia Graft
5. Insetting the Grafts
6. DuraGen Placement

6. Craniotomy Repair

7. Closure

1. Muscle Closure
2. Craniotomy Repair

8. Repair of Tympanic Membrane Perforation

1. Removal of Pressure-Equalization Tube
2. Paper Patch