Kutz JW, et al. - Experts ascertained the presentation, surgical findings, and outcomes in patients with spontaneous temporal bone cerebrospinal fluid (CSF) fistulas and encephaloceles. In obese females, spontaneous CSF fistulas were most commonly seen and ought to be suspected with a chronic middle ear effusion, persistent otorrhea after tympanostomy tube placement, or in patients with a history of meningitis. A high success rate with a low incidence of postoperative complications was noted with the middle fossa craniotomy approach with the use of hydroxyapatite bone cement.