CSF otorrhoea

Dr Craig Hacking and Dr M Venkatesh et al.

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

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.

  • congenital
    • labyrinthine malformation
    • abnormal development of facial canal
    • bony and dural defects along the temporal bone
  • iatrogenic
  • aberrantly distributed arachnoid granulations
  • infection
  • traumatic 
  • neoplastic

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.

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Article information

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

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