“…In our experience of using HE in 14 cases of primary CSF leak repair, the leak rate was 7% (one patient) in keeping with but at the lower end of that documented in the literature, 6 and there were no graft-associated adverse events or cases of postoperative meningitis recorded. Therefore, we have found that HE was an effective material for CSF leak repair in primary cases, or smaller CSF leaks, but we would be cautious in revision cases, more extensive or high-flow leaks, preferring more established techniques (facia lata or nasoseptal flap) in such instances.…”