Cerebrospinal fluid otorrhea treated by extended subtotal petrosectomy with obliteration

Extended subtotal petrosectomy as a treatment for stubborn cerebrospinal fluid (CSF) otorrhea is presented. Nine patients were successfully operated on by this technique, all previously having undergone surgery for brain or base of skull lesions, other interventions used had failed to seal the fistula. The retrosigmoid cells, facial cells, and internal auditory canal were found in our study to be the most commonly involved during pervious neurosurgery and so constituted the usual path for CSF leakage. Total exenteration of middle ear and mastoid cell tracts, skeletization of sigmoid sinus, jugular bulb and facial nerve, drilling out of the semicircular canals, vestibulum, and cochlea, and skeletization of the internal auditory canal are the main steps of this approach.