The patient was operated by me for dural defect in the left middle fossa with double lyodura repair, after what CSF leak took place for 8 days.

The patient was taken to the operating room and a huge piece of muscle was harvested from the right quadriceps femoris muscle. The craniotomy site was refreshed in the left temporal area and the ear reflected down and the muscle anteriorly. Inspection of the defect site was possible after removing the external layer of the lyodura. There is CSF leak from the most medial edge of the stitched lyodura near the emergence of the left middle meningeal artery. Double stitch with muscle piece to aid more tight closure was used to water-tightly close the defect. All the suspicious points, even without CSF leak were dealt the same manner. All the free spaces were filled with muscle, which was dissected to several extensions to conform the cavities and stitched to the surround to prevent possible migration of these extensions.

Routine closure of the wound.  Smooth postoperative recovery  and the ear left exposed out of the dressing.

The patient has huge dural defect and the new brands of lyodura are lacking the older versions characteristics by less elasticity and they are more thin.  In this case even with double layer lyodura CSF leak took place, which is impermissible.

The new brands of Glue are also lacking the strong adherence.

These data conclude, that do not relay upon new brands of medical products. They could mislead you and make you do double efforts to resolve your problem.

FDA and other alike organizations must be more strict in regulation to prevent greed of the major medical companies extend and affect the patient health.