This article is a systematic review of surgical approaches to repair tegmen bony defects, which are defects of the lateral skull base. The review analyzed 42 studies that included a total of 1,738 procedures. The most common symptom associated with tegmen defects was CSF otorrhea, and the defects were often spontaneous but could also be caused by chronic otitis media, cholesteatoma, iatrogenic factors, or trauma. Surgical repair was carried out using trans mastoid, middle cranial fossa, or a combined approach, and various materials were used for grafting. Perioperative complications included persistent CSF leak, meningitis, altered mental status, facial paresis, and the need for additional procedures. Tegmen repair is generally well tolerated and has a low recurrence rate. [Extracted from the article]