Fig. 1.

Soft tissue is used to pack potential conduits of CSF drainage. A: The surgical defect following translabyrinthine approach to the IAC. Cortical bone and exposed dura remain along the tegmen; open air cells and aditus ad antrum (AAA) remain as potential paths for CSF to the middle ear. B,C: Soft tissue is used to pack the attic (medial and lateral to the ossicles), open air cells at the root of the zygoma (ROZ) and the vestibule (Vb). D: After petrous cells are packed, pressed Gelfoam is placed over remaining contents of the IAC and fascial graft is draped over the bony defect (FN: facial nerve; JB: jugular bulb).