Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-30T23:41:14.470Z Has data issue: false hasContentIssue false
  • English
  • Français

Spontaneous resolution of cerebrospinal fluid otorrhoea in a patient with a Hyrtl's fissure

Published online by Cambridge University Press:  05 August 2015

R Brar ,
A Vijendren ,
M Salam  and
G Picken
R Brar*
Affiliation:
Department of ENT, Ipswich Hospital Trust, UK
A Vijendren
Affiliation:
Department of ENT, Ipswich Hospital Trust, UK
M Salam
Affiliation:
Department of ENT, Ipswich Hospital Trust, UK
G Picken
Affiliation:
Department of Radiology, Ipswich Hospital Trust, UK
*
Address for correspondence: Dr Ravinder Brar, Department of ENT, Ipswich Hospital Trust, Heath Road, Ipswich IP4 5PD, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This paper reports a rare case of cerebrospinal fluid leak due to a Hyrtl's fissure and discusses the non-operative management of the case.

Background and case report:

Cerebrospinal fluid otorrhoea is a rare phenomenon arising from an abnormal communicating tract between the subarachnoid space and middle ear. Affected patients are at a higher risk of developing meningitis and other neuro-otological complications. There are four common congenital causes of cerebrospinal fluid otorrhoea in the region of a normal labyrinth. This paper describes a case of cerebrospinal fluid in the middle ear resulting from a Hyrtl's fissure, which resolved spontaneously.

Conclusion:

A literature search indicated this to be the first case with such a resolution without the need for any intervention.

Keywords

Congenital FissureCerebrospinal Fluid OtorrheaEar Diseases
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 8 , August 2015 , pp. 817 - 819
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Medscape. CSF otorrhea. In: http://emedicine.medscape.com/article/883160-overview [22 July 2014]Google Scholar
2Pachauri, R, Nagasonkar, S, Kirtane, MV. Spontaneous CSF otorrhoea – presenting as conductive deafness. Indian J Otolaryngol Head Neck Surg 2002;54:51–4CrossRefGoogle ScholarPubMed
3Brown, NE, Grundfast, KM, Jabre, A, Megerian, CA, O'Malley, BW Jr, Rosenberg, SI. Diagnosis and management of spontaneous cerebrospinal fluid-middle ear effusion and otorrhea. Laryngoscope 2004;114:800–5CrossRefGoogle ScholarPubMed
4Savva, A, Taylor, MJ, Beatty, CW. Management of cerebrospinal fluid leaks involving the temporal bone: report on 92 patients. Laryngoscope 2003;113:50–6CrossRefGoogle ScholarPubMed
5Gacek, RR, Leipzig, B. Congenital cerebrospinal otorrhea. Ann Otol Rhinol Laryngol 1979;88:358–65CrossRefGoogle ScholarPubMed
6Gacek, RR, Gacek, MR, Tart, R. Adult spontaneous cerebrospinal fluid otorrhea: diagnosis and management. Am J Otol 1999;20:770–6Google ScholarPubMed
7Jegoux, F, Malard, O, Gayet-Delacroix, M, Bordure, P, Legent, F, Beauvillain de Montreuil, C. Hyrtl's fissure: a case of spontaneous cerebrospinal fluid. AJNR Am J Neuroradiol 2005;26:963–6Google ScholarPubMed
8Rich, PM, Graham, J, Phelps, PD. Hyrtl's fissure. Otol Neurotol 2002;24:476–82CrossRefGoogle Scholar
9Mouzali, A, Ouennoughi, K, Haraoubia, MS, Zemirli, O, Triglia, JM. Cochlear implant electrode array misplaced in Hyrtl's fissure. Int J Pediatr Otorhinolaryngol 2011;75:1459–62CrossRefGoogle ScholarPubMed
10Spector, GJ, Lee, D, Carr, C, Davis, G, Schnettgoecke, V, Strauss, M et al. Later stages of development of the periotic duct and its adjacent area in the human fetus. Laryngoscope 1980;90:1–31CrossRefGoogle ScholarPubMed
11Levenson, MJ, Desloge, RB, Parisier, SC. Beta-2 transferrin: limitations of use as a clinical marker for perilymph. Laryngoscope 1996;106:159–61CrossRefGoogle ScholarPubMed
12Kutz, JW, Husain, IA, Isaacson, B, Roland, PS. Management of spontaneous cerebrospinal fluid otorrhea. Laryngoscope 2008;118:2195–9CrossRefGoogle ScholarPubMed
13Kveton, JF, Goravalingappa, R. Elimination of temporal bone cerebrospinal fluid otorrhea using hydroxyapatite cement. Laryngoscope 2000;110:1655–9CrossRefGoogle ScholarPubMed