Abstract
Spontaneous CSF otorrhea specially in older age is a rare condition. Congenital inner ear malformation is one of the commonest causes in pediatric age group and either because of trauma or spontaneously it comes out into middle ear. In pediatric age group usual presentation is with history of meningitis while adult patients may present as watery discharge from nose or ear. This is a case, presented with conducted deafness with negative middle ear pressure. Grommet was put presuming secretory otitis media but B2-transferrin levels of the secretion confirmed it as a CSF otorrhea. He was operated with past aural transmasioid approach. The defect was sealed in layers. Patient is in regular follow up is asymptomatic and without any recurrence.
Key Words: Spontaneous, Ventilation, Dehiscence, Arachnoid granulation
Full Text
The Full Text of this article is available as a PDF (369.4 KB).
References
- 1.Valtonen H., Geyer C, Tarlov E, Heilman C, Poe D. Tegmental defects and cerebrospinal fluid otorrhea. Orl; Journal of Oto-Rhino-Laryngology and its related species. 2001;63(1):46–52. doi: 10.1159/000055705. [DOI] [PubMed] [Google Scholar]
- 2.Kuhweide Rudolf, Casselman Jan W. Spontaneous cerebrospinal fluid otorrhea form a tegmen detect: transmastoid repair with minicraniotomy. Ann Otol rhinol laryngol. 1999;108:653–658. doi: 10.1177/000348949910800706. [DOI] [PubMed] [Google Scholar]
- 3.Gacek RR, Leipzig B. Congenital cerebrospinal otorrhea. Ann otol rhinol laryngol. 1979;88:358–65. doi: 10.1177/000348947908800311. [DOI] [PubMed] [Google Scholar]
- 4.Forguson BJ, Wilkins RH, Hudson W. Spontaneous CSF otorrhea form tegmen and posterior fossa defects. Laryngoscope. 1986;96:635–44. doi: 10.1288/00005537-198606000-00009. [DOI] [PubMed] [Google Scholar]
- 5.Lang DV. Macroscopic bony deficiency of the tegmen tympani in adult temporal bones. J Laryngol Otol. 1983;97:685–8. doi: 10.1017/S0022215100094834. [DOI] [PubMed] [Google Scholar]
- 6.Neely JG, Neblett CR, Rose JE. Diagnosis and treatment of spontaneous cerebrospinal fluid otorrhea. Laryngoscope. 1982;92:609–12. doi: 10.1288/00005537-198206000-00001. [DOI] [PubMed] [Google Scholar]
- 7.Gacek RR. Arachnoid granulation cerebrospinal fluid otorrhea. Ann otol rhinol laryngol. 1990;99:854–62. doi: 10.1177/000348949009901102. [DOI] [PubMed] [Google Scholar]
- 8.Kaufman B, Nulsen FE, Weiss MH, Brodkey JS, White RJ, Sykora GF. Acquired spontaneous non traumatic normal pressure cerebrospinal fluid fistulas originating from the middle fossa. Radiology. 1977;122:379–87. doi: 10.1148/122.2.379. [DOI] [PubMed] [Google Scholar]
- 9.Sikand A, Longridge N. CSF otorrhea complicating osteoradionecrosis of the temporal bone. Journal of Otolaryngology. 1991;20(3):209–11. [PubMed] [Google Scholar]
- 10.Skedros DG, Cass SP, Hirsch BE, Kelly RH. B2 transferrin assay in clinical management of cerebral spinal fluid and perilymphatic fluid leaks. Journal of otolaryngology. 1993;22(5):341–4. [PubMed] [Google Scholar]
- 11.mcGuirt WF, Stool SE. Cerebrospinal fluid fistuala: the identification and management in pediatric temporal bone features. Laryngoscope. 1995;105(4):359–64. doi: 10.1288/00005537-199504000-00003. [DOI] [PubMed] [Google Scholar]
- 12.Gacek RR. Evaluation and management of temporal bone arachnoid granulation. Arch Otolaryngol Head and Neck surgery. 1992;118:327–32. doi: 10.1001/archotol.1992.01880030119024. [DOI] [PubMed] [Google Scholar]
- 13.Adkins WY, Osguthorpe JD. Mini craniotomy for management of CSF otorrhea from legmen defect. Laryngoscope. 1983;93:1038–40. doi: 10.1288/00005537-198308000-00012. [DOI] [PubMed] [Google Scholar]