cerebrospinal fluid otorrhea

Summary

Summary: Discharge of cerebrospinal fluid through the external auditory meatus or through the eustachian tube into the nasopharynx. This is usually associated with CRANIOCEREBRAL TRAUMA (e.g., SKULL FRACTURE involving the TEMPORAL BONE;), NEUROSURGICAL PROCEDURES; or other conditions, but may rarely occur spontaneously. (From Am J Otol 1995 Nov;16(6):765-71)

Top Publications

  1. Savva A, Taylor M, Beatty C. Management of cerebrospinal fluid leaks involving the temporal bone: report on 92 patients. Laryngoscope. 2003;113:50-6 pubmed
    To investigate the success of different surgical and nonsurgical techniques in the management of cerebrospinal fluid otorrhea or otorhinorrhea.
  2. Valtonen H, Geyer C, Tarlov E, Heilman C, Poe D. Tegmental defects and cerebrospinal fluid otorrhea. ORL J Otorhinolaryngol Relat Spec. 2001;63:46-52 pubmed
    ..A combination mastoid and middle fossa approach for definitive repair is suggested...
  3. Rao A, Merenda D, Wetmore S. Diagnosis and management of spontaneous cerebrospinal fluid otorrhea. Otol Neurotol. 2005;26:1171-5 pubmed
    To describe the clinical presentation, diagnosis, surgical management, and outcome of patients with spontaneous cerebrospinal fluid otorrhea.
  4. Son H, Karkas A, Buchanan P, Giurintano J, Theodosopoulos P, Pensak M, et al. Spontaneous cerebrospinal fluid effusion of the temporal bone: repair, audiological outcomes, and obesity. Laryngoscope. 2014;124:1204-8 pubmed publisher
    ..In our patient cohort with spontaneous CSF effusion, we report its association with obesity and audiological findings before and after surgery...
  5. Schnabel C, Di Martino E, Gilsbach J, Riediger D, Gressner A, Kunz D. Comparison of beta2-transferrin and beta-trace protein for detection of cerebrospinal fluid in nasal and ear fluids. Clin Chem. 2004;50:661-3 pubmed
  6. Perheentupa U, Kinnunen I, Grenman R, Aitasalo K, Makitie A. Management and outcome of pediatric skull base fractures. Int J Pediatr Otorhinolaryngol. 2010;74:1245-50 pubmed publisher
    ..This retrospective study was undertaken at a tertiary care academic hospital to evaluate the management and outcome of pediatric skull base fractures...
  7. Weber S, Kim J, Delashaw J, Wax M. Radial forearm free tissue transfer in the management of persistent cerebrospinal fluid leaks. Laryngoscope. 2005;115:968-72 pubmed
    ..Although numerous repair methods have been successful, the occasional patient develops a persistent leak. We describe our experience with free tissue transfer for repair of recalcitrant CSF leaks...
  8. Cappabianca P, Cavallo L, Esposito F, Valente V, de Divitiis E. Sellar repair in endoscopic endonasal transsphenoidal surgery: results of 170 cases. Neurosurgery. 2002;51:1365-71; discussion 1371-2 pubmed
    ..To describe techniques and materials used in sellar repair after an endoscopic endonasal transsphenoidal approach...
  9. Ibekwe T, Ijaduola G, Nwaorgu O. Tympanic membrane perforation among adults in West Africa. Otol Neurotol. 2007;28:348-52 pubmed
    ..The knowledge of variations of the tympanic membrane (TM) perforations with the climatic changes in the West African subregion would help clinicians in its prevention and management...

More Information

Publications62

  1. Gong S, Fu Y, Zhong G, Wang P, Wang G, Li G. [The clinical manifestation and management of Mondini dysplasia]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2007;21:312-4 pubmed
    ..To improve the possibility of diagnosis of the Mondini dysplasia...
  2. Goldstein N, Mandel E, Kurs Lasky M, Rockette H, Casselbrant M. Water precautions and tympanostomy tubes: a randomized, controlled trial. Laryngoscope. 2005;115:324-30 pubmed
  3. Orlandi R, Shelton C. Endoscopic closure of the eustachian tube. Am J Rhinol. 2004;18:363-5 pubmed
    ..Cerebrospinal fluid (CSF) otorhinorrhea can rarely complicate lateral skull base surgery, necessitating sealing of the eustachian tube. Patulous eustachian tube (pET) can also be an indication for closure of the eustachian tube...
  4. Piane R, Cerase A, Mezzedimi C, Bellussi L. Spontaneous onset of CSF otorrhea from a facial canal fistula in an adult: case report. Acta Otorhinolaryngol Belg. 2001;55:279-84 pubmed
    ..When the clinical history, physical examination, and laboratory analysis are strongly suggestive for spontaneous CSF otorrhea, surgical exploration is mandatory even if neuroimaging evaluation is negative or questionable...
  5. Ozmen S, Ozmen O, Yilmaz T. Clear otorrhea: a case of Munchausen syndrome in a pediatric patient. Eur Arch Otorhinolaryngol. 2008;265:837-8 pubmed
    ..Diagnosis of Munchausen syndrome is difficult especially during the initial assessment, although suspicion might be aroused by inconsistencies in the patient's history and discrepancies between signs and symptoms...
  6. Hillman T, Shelton C. Resorbable plate cranioplasty after the translabyrinthine approach. Otol Neurotol. 2011;32:1171-4 pubmed publisher
  7. Muzzi E, Boscolo Rizzo P, Santarelli R, Beltrame M. Cochlear implant electrode array misplacement: a cautionary case report. J Laryngol Otol. 2012;126:414-7 pubmed publisher
    ..To report a series of pitfalls and complications in a case of cochlear implantation...
  8. Pagano M, Africano R, Lo Pinto G. [Wegener granulomatosis: a clinical case with parossistic positional vertigo due to involvement of the lateral semicircular canal]. Acta Otorhinolaryngol Ital. 1996;16:438-40 pubmed
  9. Kryzanski J, Annino D, Heilman C. Complication avoidance in the treatment of malignant tumors of the skull base. Neurosurg Focus. 2002;12:e11 pubmed
  10. Verhaegen V, Mulder J, Cremers C, Snik A. Application of active middle ear implants in patients with severe mixed hearing loss. Otol Neurotol. 2012;33:297-301 pubmed publisher
    ..To determine the long-term benefit of the Vibrant Soundbridge (VSB) middle ear implant in patients with severe mixed hearing loss and to compare it with other hearing devices...
  11. Maira G, Anile C, Albanese A, Cabezas D, Pardi F, Vignati A. The role of transsphenoidal surgery in the treatment of craniopharyngiomas. J Neurosurg. 2004;100:445-51 pubmed
    ..Moreover, TSS was also performed in some cases of purely suprasellar craniopharyngiomas. In this study the surgical indications and the results obtained in all patients who had undergone TSS were analyzed...
  12. Santamarta D, Blázquez J, Maillo A, Munoz A, Caballero M, Morales F. [Analysis of cerebrospinal fluid related complications (hydrocephalus, fistula, pseudomeningocele and infection) following surgery for posterior fossa tumors]. Neurocirugia (Astur). 2003;14:117-26 pubmed
    ..The objectives of this study were to review the incidence of such complications and to identify contributing factors related to them...
  13. Honda N, Okouchi Y, Sato H, Sanuki T, Hato N, Yanagihara N, et al. Bilateral spontaneous cerebrospinal fluid otorrhea. Am J Otolaryngol. 2004;25:68-72 pubmed
    ..In case of spontaneous CSF otorrhea, the roof of tegmen should be assessed bilaterally with care using radiologic examinations so as not to overlook a subclinical condition on the contralateral side...
  14. Petereit H, Bachmann G, Nekic M, Althaus H, Pukrop R. A new nephelometric assay for beta-trace protein (prostaglandin D synthase) as an indicator of liquorrhoea. J Neurol Neurosurg Psychiatry. 2001;71:347-51 pubmed
    ..To determine the sensitivity and specificity of a nephelometric beta-trace protein assay for the diagnosis of liquorrhoea...
  15. Reddy M, Baugnon K. Imaging of Cerebrospinal Fluid Rhinorrhea and Otorrhea. Radiol Clin North Am. 2017;55:167-187 pubmed publisher
    ..This article reviews the causes of CSF leaks, describes the methodology used to work up a suspected leak, and discusses the challenges of making an accurate diagnosis. ..
  16. Briggs R, Wormald P. Endoscopic transnasal intradural repair of anterior skull base cerebrospinal fluid fistulae. J Clin Neurosci. 2004;11:597-9 pubmed
    ..This study presents the techniques and results of endoscopic diagnosis and repair of cerebrospinal fluid (CSF) fistulae involving the anterior skull base and paranasal sinuses...
  17. Arai Y, Sakuma N, Sano D, Takahashi M, Matsuda H, Ikoma R, et al. [A case report: a repeated cerebrospinal fluid otorrhea]. Nihon Jibiinkoka Gakkai Kaiho. 2013;116:161-4 pubmed
    ..Although 2 years have passed since the surgery, the CSF leakage has not recurred...
  18. Warnecke A, Averbeck T, Wurster U, Harmening M, Lenarz T, Stover T. Diagnostic relevance of beta2-transferrin for the detection of cerebrospinal fluid fistulas. Arch Otolaryngol Head Neck Surg. 2004;130:1178-84 pubmed
    ..The purpose of this study was to investigate the clinical relevance of the identification of beta(2)-transferrin by comparing the test results with other diagnostic measures and intraoperative findings...
  19. Shohet J, Scherger J. Which culprit is causing your patient's otorrhea?. Postgrad Med. 1998;104:50-5, 59-60 pubmed
    ..Physicians must also be familiar with the tests appropriate for confirming otorrhea's cause. Once proper diagnosis is made, effective treatment can follow...
  20. Goh E, Son B, Kong S, Chon K, Cho K. Analysis of hepatitis B virus in the cerumen and otorrhea of chronic HBV-infected patients: is there a hepatitis B virus infectivity?. Otol Neurotol. 2008;29:929-32 pubmed publisher
    ..The object of this study was to find out whether cerumen and otorrhea have any infectivity in the transmission of hepatitis B virus (HBV)...
  21. Matsuda N, Matsuura Y, Hoshi A, Yamanoi T, Endo K, Honma M, et al. [A case of recurrent bacterial meningitis by delayed cerebrospinal fluid (CSF) leakage due to a head trauma]. Rinsho Shinkeigaku. 2002;42:158-61 pubmed
    ..Pneumococcal meningitis, once not a difficult infection to treat, could be a difficult one, as resistant strains to ABPC and CTRX have been more common...
  22. Claros P, Matusialk M. [Recurrent meningitis in inner ear malformations]. Otolaryngol Pol. 2008;62:340-3 pubmed
    ..Carefull obliteration of the Eustachian tube and both windows has been performed. Non- complicated postoperative course (2 months and 6 years - respectively) has prooved the effectiveness of applied treatment...
  23. Reilly J. Congenital perilymphatic fistula: a prospective study in infants and children. Laryngoscope. 1989;99:393-7 pubmed
    ..These children should also have radiographic imaging of their temporal bone by computed tomography scan. The use of both methods is the best indicator for congenital perilymphatic fistula...
  24. Heslop A, Lildholdt T, Gammelgaard N, Ovesen T. Topical ciprofloxacin is superior to topical saline and systemic antibiotics in the treatment of tympanostomy tube otorrhea in children: the results of a randomized clinical trial. Laryngoscope. 2010;120:2516-20 pubmed publisher
    ..To compare the clinical failure rates among children with otorrhea through tympanostomy tubes treated with topical or systemic antibiotics versus topical saline...
  25. Roncaroli F, Scheithauer B, Pires M, Rodrigues A, Pereira J. Mature teratoma of the middle ear. Otol Neurotol. 2001;22:76-8 pubmed
    ..The authors report a case of mature teratoma of the middle ear in a 3-year-old girl with a 1-year history of otitis media...
  26. Vezina J, Audet N, Fradet G. Cerebrospinal fluid otorrhoea: a rare presentation of Langerhans' cell histiocytosis of the temporal bone. J Laryngol Otol. 2010;124:545-8 pubmed publisher
    ..To report a case of Langerhans cell histiocytosis of the temporal bone presenting with cerebrospinal fluid fistula...
  27. Coulson C, George A, Biswas A, Phelan C, De R. Pseudotumour of the temporal bone: an unusual [corrected] cause of otorrhoea and facial palsy. Eur Arch Otorhinolaryngol. 2008;265:713-5 pubmed
    ..We review the key radiological and histological results that confirmed the diagnosis and demonstrated for the first time that oral steroids alone may completely resolve the condition...
  28. Leonetti J, Marzo S, Anderson D, Origitano T, Vukas D. Spontaneous transtemporal CSF leakage: a study of 51 cases. Ear Nose Throat J. 2005;84:700, 702-4, 706 pubmed
    ..1%]). The 2 patients whose leakage recurred were successfully managed with a subtotal petrosectomy with occlusion of the eustachian tube and obliteration of the middle ear and mastoid. No patient developed meningitis...
  29. Martin T, Kerschner J, Flanary V. Fungal causes of otitis externa and tympanostomy tube otorrhea. Int J Pediatr Otorhinolaryngol. 2005;69:1503-8 pubmed
    ..To describe the occurrence of fungal organisms in the setting of otitis externa and tympanostomy tube otorrhea, review the treatment course, timing of diagnosis, organism identified and time to resolution with fungal infections...
  30. Bani A, Gilsbach J. Incidence of cerebrospinal fluid leak after microsurgical removal of vestibular schwannomas. Acta Neurochir (Wien). 2002;144:979-82;discussion 982 pubmed
    ..Cerebrospinal fluid (CSF) leak still remains an unresolved problem after microsurgical removal of vestibular schwannomas (VS)...
  31. Selesnick S, Liu J, Jen A, Newman J. The incidence of cerebrospinal fluid leak after vestibular schwannoma surgery. Otol Neurotol. 2004;25:387-93 pubmed
    ..To review the incidence of cerebrospinal fluid leak after vestibular schwannoma removal reported in the literature...
  32. Sherman S, Buchanan A. Gradenigo syndrome: a case report and review of a rare complication of otitis media. J Emerg Med. 2004;27:253-6 pubmed
    ..Work-up should include a CT scan of the temporal bones. Otolaryngology consultation and admission for i.v. antibiotics is recommended...
  33. Loundon N, Leboulanger N, Maillet J, Riggouzzo A, Richard P, Marlin S, et al. Cochlear implant and inner ear malformation. Proposal for an hyperosmolar therapy at surgery. Int J Pediatr Otorhinolaryngol. 2008;72:541-7 pubmed publisher
    ..The protocol could protect the vestibular function, lowering the pressure and quantity of the liquid issue. The treatment does not seem to influence the perceptive results...
  34. Diaz Anadon A, Lassaletta L, Roda J, Gavilán Bouzas J. [CSF fistulae following surgery for cerebellopontine angle tumours and their relationship with the body mass index]. Acta Otorrinolaringol Esp. 2009;60:318-24 pubmed publisher
    ..The most frequent complication after vestibular schwannoma surgery is cerebrospinal fluid (CSF) fistula...
  35. Odutoye T, McGilligan A, Robb P. Aseptic surgical technique and postgrommet otorrhoea. Int J Pediatr Otorhinolaryngol. 2003;67 Suppl 1:S233-5 pubmed
    ..The results indicate that there is no significant difference in the incidence of postoperative otorrhoea using either of the above methods, and demonstrate that this operation may be performed in a safe but more cost-efficient manner...
  36. Alaani A, Coulson C, McDermott A, Irving R. Transtemporal approach to otogenic brain abscesses. Acta Otolaryngol. 2010;130:1214-9 pubmed publisher
    ..It has a low complication rate and avoids the need for a craniotomy or subsequent operations...
  37. Brown N, Grundfast K, Jabre A, Megerian C, O Malley B, Rosenberg S. Diagnosis and management of spontaneous cerebrospinal fluid-middle ear effusion and otorrhea. Laryngoscope. 2004;114:800-5 pubmed
    ..Data on nine cases of spontaneous CSF leak to the ear in adult patients from four medical centers are presented and analyzed to provide collective information about a disorder that can be difficult to diagnose and manage...
  38. Patil S, Trinidade A, Yung M, Donnelly N. Cerebrospinal fluid otorrhoea following grommet insertion: management using a multi-layered graft technique and an important lesson revisited. J Laryngol Otol. 2013;127:70-2 pubmed publisher
    ..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...
  39. Lou Z. Healing large traumatic eardrum perforations in humans using fibroblast growth factor applied directly or via gelfoam. Otol Neurotol. 2012;33:1553-7 pubmed publisher
    ..The goal of this study was to evaluate the effects of conservative treatment and fibroblast growth factor (FGF) applied directly or via Gelfoam on the healing of large traumatic tympanic membrane perforations (TMPs) in humans...
  40. Roman B, Coelho D, Roland J. Implantation of the common cavity malformation may prevent meningitis. Cochlear Implants Int. 2013;14:56-60 pubmed
    ..However, they may also benefit from cochlear implantation. We suggest that surgical management may be possible that both prevents meningitis and provides hearing rehabilitation during the same procedure...
  41. Iino Y, Imamura Y, Harigai S, Tanaka Y. Efficacy of tympanostomy tube insertion for otitis media with effusion in children with Down syndrome. Int J Pediatr Otorhinolaryngol. 1999;49:143-9 pubmed
    ..The present study was carried out to determine the efficacy of tympanostomy tube insertion in children with Down syndrome...
  42. Forgacs P, Geyer C, Freidberg S. Characterization of chemical meningitis after neurological surgery. Clin Infect Dis. 2001;32:179-85 pubmed
    ..They rarely had temperatures > 39.4 degrees C or cerebrospinal fluid rhinorrhea or otorrhea...
  43. Qiu J, Chen Y, Tan P, Chen J, Han Y, Gao L, et al. Complications and clinical analysis of 416 consecutive cochlear implantations. Int J Pediatr Otorhinolaryngol. 2011;75:1143-6 pubmed publisher
    ..However, certain complications may require specific attention to treat. The purpose of this study was to investigate complications of cochlear implantation for prevention and therapy...
  44. Yamakami I, Uchino Y, Kobayashi E, Saeki N, Yamaura A. Prognostic significance of changes in the internal acoustic meatus caused by vestibular schwannoma. Neurol Med Chir (Tokyo). 2002;42:465-70; discussion 470-1 pubmed
    ..Severe IAM change increases the technical difficulty of tumor removal and the risk of postoperative CSF leakage, and is associated with a poorer prognosis for patients with vestibular schwannoma...
  45. Isaacson J, Linder T, Fisch U. Arachnoid cyst of the fallopian canal: a surgical challenge. Otol Neurotol. 2002;23:589-93 pubmed
    ..We report a seventh case that is unique in that it involves an arachnoid cyst of the fallopian canal and an associated facial nerve palsy...
  46. Castillo López I, Muñoz Lozano A, Bonner Osorio C. [Post-traumatic cholesteatoma with posterior fossa invasion]. Acta Otorrinolaringol Esp. 2011;62:318-9 pubmed publisher
    ..Its physiopathology and clinical manifestations are discussed...
  47. Görögh T, Rudolph P, Meyer J, Werner J, Lippert B, Maune S. Separation of beta2-transferrin by denaturing gel electrophoresis to detect cerebrospinal fluid in ear and nasal fluids. Clin Chem. 2005;51:1704-10 pubmed
    ..Cerebrospinal fluid (CSF) leakage is a critical condition with a substantial risk of meningitis. We investigated the use of transferrin isoform analysis as a diagnostic marker for detection of CSF leakage in fluid samples...
  48. Kisser U, Gurkov R, Louza J, Schrötzlmair F, Adderson Kisser C, Krause E. Comparison of characteristics of titanium and fluoroplastic ventilation tubes in adults with healthy middle ears. Otol Neurotol. 2012;33:983-7 pubmed publisher
    ..In this study, we analyzed extrusion rates and adverse effects of fluoroplastic, titanium, and gold ventilation tubes of different sizes in adult patients with Ménière's disease...
  49. Wolter N, Dell S, James A, Campisi P. Middle ear ventilation in children with primary ciliary dyskinesia. Int J Pediatr Otorhinolaryngol. 2012;76:1565-8 pubmed publisher
  50. Sughrue M, Yang I, Aranda D, Rutkowski M, Fang S, Cheung S, et al. Beyond audiofacial morbidity after vestibular schwannoma surgery. J Neurosurg. 2011;114:367-74 pubmed publisher
    ..In addition, the majority of reports have focused on outcomes related to cranial nerves (CNs) VII and VIII. The objective of this study was to analyze reported morbidity unrelated to CNs VII and VIII following the resection of VS...
  51. Lin C, Lin H, Peng C, Lee K, Chiu N. Mondini dysplasia presenting as otorrhea without meningitis. Pediatr neonatol. 2012;53:371-3 pubmed publisher
    ..Temporal bone computed tomography should be considered in children with unilateral sensorineural or mixed-type hearing impairment...
  52. Miller B, Hillman T. An evaluation of the risk of cerebrospinal fluid leakage as a function of the surgical approach to the cochlear nerve. Laryngoscope. 2006;116:1276-8 pubmed
    ..Cochlear nerve implantation demands a unique surgical exposure to the modiolus. This study comprises an assessment of the risk of generating an intraoperative cerebrospinal fluid (CSF) leak using this approach...
  53. Pino Rivero V, Gonzalez Palomino A, Trinidad Ramos G, Pantoja Hernandez C, Pardo Romero G, Rejas Ugena E, et al. [Otogenic cerebrospinal fistula. Report of an atypical case]. An Otorrinolaringol Ibero Am. 2006;33:461-6 pubmed
    ..The woman was operated by ORL (closing the fistula) and neurosurgery (placing an external lumbar drainage) with good postsurgical evolution...