Surgical Repair of Dural Herniation Into the Mastoid Bowl

Abstract

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. <h3>Review of Literature</h3> In 1727, Vander Weil reported the first case of watery fluid escaping from an ear following head trauma.¹This 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.²The first reported surgical repair of a post-operative dural fistula was by Canfield in 1913.³He 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.