Endaural Subtemporal Approach for Middle Fossa Encephalocele and CSF Leak Repair

Idiopathic temporal bone meningoencephalocele with CSF leak is most often treated via middle fossa craniotomy and dural repair with good results. This approach provides wide exposure of the middle fossa floor and temporal lobe dura. However, in cases of focal tegmen dehiscence, adequate exposure for encephalocele resection and repair of CSF fistula can be obtained through a keyhole craniotomy and cosmetically favorable endaural incision. We present three patients successfully treated for idiopathic temporal bone encephalocele with CSF leak via an endaural subtemporal (EAST) keyhole craniotomy.