Cartilage butterfly graft to repair temporal bone CSF leak

Abstract

Temporal bone cerebral spinal fluid (CSF) leak is a condition characterized by continuous CSF leakage from the intracranial cavity into the middle ear space. Prompt surgical management is warranted as temporal bone CSF leaks may lead to serious infections such as meningitis and encephalitis. There are several methods and materials utilized to repair tegmen defects that cause CSF leaks. Herein, we describe a novel technique to repair the tegmen in patients with temporal bone CSF leak utilizing a tragal cartilage butterfly graft. Cartilage is a readily available, generously biocompatible, resistant to deformation and an inherently pliable graft material. Butterflied cartilage grafts provide unique benefit allowing both intracranial and extracranial support to seal tegmen defects with the placement of a single piece of graft material.