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Spontaneous bilateral and concurrent cerebrospinal fluid otorrhoea: case presentation and literature review

Published online by Cambridge University Press:  05 July 2016

T Tikka ,
A Opeodu ,
R Irving  and
J Murphy
T Tikka*
Affiliation:
Department of ENT, New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, UK
A Opeodu
Affiliation:
Department of ENT, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, UK
R Irving
Affiliation:
Department of ENT, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, UK
J Murphy
Affiliation:
Department of ENT, New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, UK
*
Address for correspondence: Miss Theofano Tikka, Department of ENT, New Cross Hospital, Wolverhampton WV10 0QP, UK E-mail: [email protected]
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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.

Keywords

Otorrhea, Cerebrospinal Fluid, Spontaneous
Type
Clinical Record
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 8 , August 2016 , pp. 781 - 786
Copyright
Copyright © JLO (1984) Limited 2016 

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