Surgical Management of Cerebrospinal Fluid (CSF) Otorrhea Presenting as CSF Rhinorrhea: Different Approaches

Mehta Madhuri, Morwani KP and Arsiwala Zainab

Department of Ent, N.C. Jindal Institute of Medical Sciences, India

^*Correspondance to: Mehta Madhuri 

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Abstract:

CSF otorrhea though a rare clinical entity, is a life threatening situation that requires rapid intervention. Though occurring through the otologic structure, actual leakage from the ear may not always be present (unless the ear drum or canal is in some way violated), but the fluid may flow down the Eustachian tube and manifests as a clear fluid through the nose. The presence of an abnormal communication of the sterile subarachnoid space with the flora of the sinonasal tract, places the patient at a great risk of meningitis. Diagnosis of such cases, need a high index of suspicion, complete clinical examination of nose and ear and relevant investigations to avoid unnecessary nasal exploration and prevent life threatening meningitis. This case report presents the diagnosis and management of two cases of CSF otorrhea presenting as CSF rhinorrhea, one having a spontaneous leak, and the other following trauma. Mention is made of how one could subject a patient to inadequate surgery, if one is not vigilant and adequate investigations are not carried out. Different methods of repair depending on the site and size of defects are outlined in the two different cases. Consent was obtained from each case in the format mentioned towards the end.

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Cite the Article:

Madhuri M, Morwani KP, Zainab A. Surgical Management of Cerebrospinal Fluid (CSF) Otorrhea Presenting as CSF Rhinorrhea: Different Approaches. Ann Clin Case Rep. 2017; 2: 1395.