Endaural brain hernia: repair using mastoid cortical bone

We present three cases of endaural brain hernia and a method of repair using sculptured mastoid cortical bone. The literature is reviewed to illustrate etiology, pathology, clinical presentation, and management options of this uncommon clinical entity. We classify the hernias as pedunculated or sessile, with associated factors such as viability of herniated brain, infection, CSF leak, and neurologic complications. A management scheme is proposed encompassing surgical options now available and their attendant risks and complications.