Many substances have been used as dural substitutes. Although the various materials are effective in a variety of settings, a material that is absorbed over time, elicits minimal inflammatory reaction, is relatively inexpensive, and is easily manipulated would be beneficial. An experimental project was conducted involving closure of dural defects in dogs with a Vicryl (polyglactin 910) mesh graft. Macroscopic and histological examination performed at various times after placement revealed resorption of the graft material, little cerebromembranous adhesion formation, and complete lack of injury to subjacent cortical zones. A substantial neomembrane forms over the zone of the mesh graft. The authors suggest that Vicryl mesh has significant potential as an absorbable, minimally reactive dural substitute.

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A case of cerebellopontine angle meningioma with restoration of hearing from a profoundly deaf state is presented. Meningiomas of the posterior fossa commonly present with decreased or absent hearing and can appear deceptively similar to acoustic neurinomas on radiographic and audiometric testing. Because total restoration of hearing can occur with meningioma, even with significant preoperative deficit, utilization of the translabyrinthine approach is less desirable if any preoperative question as to the diagnosis exists. Any hearing-impaired patient with a cerebellopontine angle mass that is not conclusively thought to represent acoustic neurinoma should be approached by the suboccipital technique to maximize the opportunity for restoration of hearing.