Aim:There is a feared complication for cerebrospinal fluid (CSF) leakage after microvascular decompression (MVD). In this study we present our experience of fleece-bound tissue sealing in MVD with our aim to minimize the rate of postoperative CSF leakage.Material and Methods:We treated 50 patients (female/male: 26/24) with neurovascular compression (NVC) syndromes (trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia) by MVD from the year 2003 to 2006. All patients underwent retromastoid craniectomy and duraplasty by fleece-bound tissue sealing using the so-called sandwich technique by a three-layer reconstruction and cranioplasty.Results:In 48 of 50 patients (98%) we observed no postoperative CSF leakage. One patient (2%) suffered from postoperative cerebrospinal fluid leakage, surgical revision was performed in that patient.Conclusion:Fleece-bound tissue sealing by a three-layer reconstruction is effective and safe in the prevention of cerebrospinal fluid leakage in microvascular decompression.