CSF otorrhea

CSF otorrhea is defined as leakage of cerebrospinal fluid (CSF) from the subarachnoid space into the middle ear cavity or mastoid air cells (cf. CSF rhinorrhea)

There are a number of underlying causes, and thus no specific demographic is affected. 

Patients typically present with conductive deafness and a watery discharge from the ear (requiring a defect in the tympanic membrane).

The diagnosis can be confirmed by identifying beta-2 transferrin in the fluid.

Findings on CT cisternography include:

  • soft tissue mass with adjacent bony defect
  • leakage of contrast into middle ear cavity
  • bony defects
  • labyrinthine malformations
  • fistulous tracts 
  • enlarged labyrinthine facial nerve canal

Findings include:

  • CSF signal intensity in the bony defects
  • CSF signal intensity in middle ear cavity
  • associated empty sella
  • dural enhancement after gadolinium administration

In complex cases nuclear cisternography may be performed.

Share article

Article information

rID: 25526
System: Head & Neck
Synonyms or Alternate Spellings:
  • CSF otorrhea

Support Radiopaedia and see fewer ads

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.