Spontaneous bilateral and concurrent cerebrospinal fluid otorrhoea: case presentation and literature review.
The Journal of Laryngology & Otology 2016;
130:781-6. [PMID:
27377193 DOI:
10.1017/s0022215116008458]
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Abstract
BACKGROUND
Cerebrospinal fluid otorrhoea is a rare entity. Only a few cases of spontaneous bilateral cerebrospinal fluid otorrhoea have been reported. In all cases, there was a definite time interval between the two (left and right) presentations.
OBJECTIVES
To raise awareness and report on the very rare entity of bilateral spontaneous cerebrospinal fluid otorrhoea.
CASE REPORT
This paper reports the case of a bilateral, synchronous, spontaneous cerebrospinal fluid otorrhoea in a 44-year-old female. The patient had grommets surgically inserted on two separate occasions for treatment of otitis media with effusion, and received several courses of oral and topical antibiotics. Five years following the patient's initial presentation, a suspicion of concurrent bilateral cerebrospinal fluid otorrhoea was raised. The otorrhoea sample collected proved to be cerebrospinal fluid. Cross-sectional imaging revealed bilateral defects in the tegmen tympani of the skull base. She underwent staged middle fossa craniotomies to repair the defects.
CONCLUSION
Careful observation of the middle-ear fluid characteristics following myringotomy can allow for prompt diagnosis.
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