Dural Tears and Cerebrospinal Fluid Leak During and After the Middle Fossa Repair of Superior Canal Dehiscence Syndrome

Iatrogenic dural microtears with intraoperative CSF microleak are common (∼18%) but overwhelmingly minor and effectively repaired intraoperatively. Larger intraoperative leaks requiring lumbar drain occurred in 4% of cases, while clinically significant postoperative CSF leaks were rare (2.1%). Older age, systemic hypertension, and tegmen dehiscence are independently associated with increased leak risk, although the overall clinical impact was modest.