Lateral Skull Base Surgical Approaches

Abstract

Cerebrospinal fluid (CSF) leaks from the lateral skull base commonly present with a persistent, colorless middle ear effusion or clear otorrhea in the presence of a tympanic membrane perforation or following a myringotomy procedure. Additional associated symptoms include conductive hearing loss secondary to middle ear fluid or encephalocele, aural fullness, CSF rhinorrhea by passage through the Eustachian tube, or spontaneous meningitis. Surgical intervention is often necessary to repair the defect and limit the risk of future meningitis. The middle fossa approach is the preferred approach for repair of lateral skull base CSF leaks, and the translabyrinthine or transmastoid approaches may also be considered in select cases.