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Cerebrospinal fluid otorrhoea following grommet insertion: management using a multi-layered graft technique and an important lesson revisited

Published online by Cambridge University Press:  10 December 2012

S Patil ,
A Trinidade ,
M Yung  and
N Donnelly
S Patil
Affiliation:
Department of Otolaryngology, Ipswich Hospital, Ipswich, UK
A Trinidade*
Affiliation:
Department of Otolaryngology, James Paget Hospital, Gorleston, Great Yarmouth, UK
M Yung
Affiliation:
Department of Otolaryngology, Ipswich Hospital, Ipswich, UK
N Donnelly
Affiliation:
Department of Otolaryngology, Addenbrooke's Hospital, Cambridge, UK
*
Address for correspondence: Mr A Trinidade, Department of Otolaryngology, James Paget Hospital, Gorleston, Great Yarmouth NR31 6LA, UK E-mail: [email protected]
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Abstract

Background:

A spontaneous cerebrospinal fluid leak can sometimes only become apparent following grommet insertion and usually represents dehiscence of the tegmen tympani, which is an uncommon condition.

Objectives:

This report aimed to reaffirm the importance of recognising this unusual presentation and outline management options.

Case report:

A 63-year-old man with conductive hearing loss and type B (flat) tympanometry underwent grommet insertion into his left ear, which resulted in cerebrospinal fluid otorrhoea. A defect of the tegmen tympani was found. This was successfully repaired via a transmastoid approach using a multi-layered grafting technique.

Conclusion:

Dehiscence of the tegmen tympani is uncommon and may only come to light following grommet insertion, which may be problematic for the uninformed otolaryngologist. Education is important to ensure early recognition and appropriate management.

Keywords

Tympanostomy Tube InsertionCerebrospinal FluidTemporal Bone
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 1 , January 2013 , pp. 70 - 72
Copyright
Copyright © JLO (1984) Limited 2012

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Footnotes

Presented orally at the 140th Semon Club, 19 November 2010, London, UK.

References

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