Middle Cranial Fossa Repair of Cerebrospinal Fluid Leak with Bone Cement
09-10, 17:40–17:50 (Europe/Istanbul), Otology 5

<p>Introduction: Spontaneous cerebrospinal fluid (CSF) leaks of the temporal bone occur when a defect in the lateral skull base and dura mater occurs, allowing egress of cerebrospinal fluid into pneumatized spaces of the temporal bone, resulting in increased risk of meningitis, and often conductive hearing loss as well as clear rhinorrhea or otorrhea. While multiple surgical routes exist, the Middle Cranial Fossa (MCF) approach allows for comprehensive visualization of the entire middle fossa skull base, enabling robust repair of multiple defects.</p> <p>Methods/Surgical Technique: This "Masters in Surgery" video presentation details the surgical management of a spontaneous CSF leak in a patient presenting with conductive hearing loss. The video highlights technical aspects and techniques of this approach, including the craniotomy, dural elevation, identification of tegmental dehiscence, and the meticulous application of hydroxyapatite bone cement for reconstruction.</p> <p>Results/Discussion: Outcomes of this presentation will be to provide a detailed demonstration that the audience may apply to their practice, with high-quality operative video that highlights key aspects to safe and successful repair of CSF leaks via the middle cranial fossa approach. The presentation will also generate discussion among experts regarding improved care for patients with spontaneous CSF leaks.</p> <p>Conclusion: The MCF approach with bone cement reconstruction is a highly effective, durable technique for the management of spontaneous CSF leaks. This video serves as a technical guide for neurotologists to refine their approach to complex skull base repairs to optimize patient outcomes.</p>
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Session Chair Session Chair
isa dagli
Speaker Speaker
Evan Cumpston
isa dagli
<p>Dr. isa dagli</p> <p>I was born in 1988, Konya, Turkey</p> <p>I graduated from Hacettepe University Faculty of Medicine</p> <p>I specialized in Ear Nose Throat and Head and Neck Surgery at İzmir Tepecik Training and Research Hospital</p> <p>My area of ​​expertise is otology-neurotology and I am particularly interested in endoscopic ear surgery.</p>
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Evan Cumpston
<p>Dr. Evan Cumpston is a neurotologist and Skull base surgeon at Indiana University School of Medicine Department of Otolaryngology—Head and Neck Surgery. His expertise encompasses the removal of benign tumors, such as vestibular schwannomas (acoustic neuromas), meningiomas, paragangliomas (glomus tumors), facial nerve tumors, and cholesterol granulomas. He also has expertise in removing malignant tumors involving the temporal bone, such as squamous cell carcinoma.</p> <p>In addition, Dr. Cumpston specializes in surgeries for hearing loss, including cochlear implant surgery and stapes surgery. He also performs repairs for cerebrospinal fluid (CSF) leak repairs, disorders of the facial nerve, and surgery for chronic ear disease.</p> <p>Dr. Cumpson's research is dedicated to enhancing hearing outcomes for cochlear implant recipients and optimizing clinical outcomes in skull base surgeries. He is the director of the IU Otolaryngology Temporal Bone Course and is passionate about medical education, mentoring medical students, residents, and fellows.</p>
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