Extra-dural repair of symptomatic tegmen defects through mini-temporal craniotomy: Our institutional experience

Tegmen tympani defects may arise from idiopathic, congenital, inflammatory, traumatic, or iatrogenic causes. Patients with persistent otorrhea are at greatest risk for meningitis, which can be morbid and often the initial presentation in patients. Temporal bone defects are commonly repaired through craniotomy, middle fossa or transmastoid approach....

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Audiologists evaluating patients with chronic ear drainage or recurrent meningitis of unclear cause should consider referring for tegmen defect workup; this case series adds institutional outcome data but is insufficient alone to change referral thresholds or surgical decision-making.

Tegmen tympani defects are an underrecognized cause of cerebrospinal fluid (CSF) otorrhea and meningitis risk, and outcome data from institutional series help refine surgical repair approaches relevant to the otology/audiology team.

1. 01Tegmen tympani defects (holes in the thin bone between the middle ear and brain) can cause CSF leakage (brain fluid leaking into the ear) and meningitis.
2. 02An extra-dural repair approach via mini-temporal craniotomy (a small skull opening) was used across the institutional case series.
3. 03The study reports outcomes including resolution of symptoms such as ear drainage and reduction in meningitis risk.
4. 04Mini-craniotomy approach avoids entering the brain lining (dura), potentially reducing complication risk.
5. 05Published in Surgical Neurology International as an institutional case series.

PMID

42694802

DOI

10.25259/SNI_601_2026.

Journal

Surgical Neurology International

Publication type

case_report

Evidence level

4

Population

Patients with symptomatic tegmen tympani defects presenting with CSF otorrhea or meningitis risk

Intervention

Extra-dural repair of tegmen defects via mini-temporal craniotomy