Cerebrospinal Fluid Otorrhea ; surgery ; Craniotomy ; Encephalocele ; Humans ; Mastoid ; surgery

Cerebrospinal Fluid Otorrhea/surgery* ; Child ; Humans ; Temporal Bone

Spontaneous cerebrospinal fluid (CSF) otorrhea is defined as CSF otorrhea where there are no identifiable causes including previous trauma, surgery, infection, neoplasm or congenital anomaly. The condition is rare. The origin of CSF leak is commonly a defect in the tegmen of the middle cranial fossa. The pathophysiology of spontaneous CSF otorrhea is unclear. Two theories of the etiology of bony defects of the temporal bone are the congenital bony defect theory and arachnoid granulation theory. The authors experienced a case of a 49-year-old female patient admitted with the complaint of persistent right ear fullness. Computed tomography revealed a large defect of the middle fossa and suspicious CSF otorrhea through the defect of tegmen tympani. Repair was successful with multiple bone chips using the transmastoid approach. The postoperative course was good and there has been no recurrence of the CSF leakage.
Arachnoid ; Cerebrospinal Fluid ; Cerebrospinal Fluid Otorrhea* ; Cranial Fossa, Middle* ; Ear ; Female ; Humans ; Middle Aged ; Recurrence ; Temporal Bone

Cerebrospinal fluid otorrhea is a rare disease entity, especially when brought on by spontaneous causes. The site of leakage should be identified to treat the disorder effectively. Various localizing modality was suggested in the literatures. Intrathecal gadolinium-enhanced magnetic resonance imaging identifies the small leakage site easily and correctly. Hydroxyapatite cement is a calcium phosphate-based material that forms dense paste mixed with water or sodium phosphate solution. Hydroxyapatite cement is remarkable for its excellent biocompatability in interacting with the native bone to osseointergrate with the surrounding bone. We report on our experience of successfully treating a patient with the cerebrospinal fluid leak from the congenital inner ear anomaly using the hydroxyapatite cement.
Calcium ; Cerebrospinal Fluid ; Cerebrospinal Fluid Otorrhea ; Durapatite* ; Ear, Inner* ; Humans ; Magnetic Resonance Imaging ; Rare Diseases ; Sodium ; Water

Cerebrospinal fluid (CSF) leakage otorrhea may be congenital or can be caused by trauma, surgery, cholesteatoma, and tumors. Spontaneous CSF leakage through the middle ear without a secondary cause is a relatively rare disease. The pathophysiology of CSF otorrhea has not been clear yet. However, there are two theories of the pathophysiology of spontaneous CSF otorrhea have been studied in the medical field: one based on the congenital defect; the other about the arachnoid granulation which causes bone erosion. Herein, we examine and report a case of CSF otorrhea caused by arachnoid granulation. Literatures pertaining to the disorder will be reviewed and characteristics of the disorder also will be discussed.
Arachnoid ; Cerebrospinal Fluid Otorrhea ; Cholesteatoma ; Ear, Middle ; Granulation Tissue ; Rare Diseases

Cerebrospinal fluid (CSF) leakage otorrhea may be congenital or can be caused by trauma, surgery, cholesteatoma, and tumors. Spontaneous CSF leakage through the middle ear without a secondary cause is a relatively rare disease. The pathophysiology of CSF otorrhea has not been clear yet. However, there are two theories of the pathophysiology of spontaneous CSF otorrhea have been studied in the medical field: one based on the congenital defect; the other about the arachnoid granulation which causes bone erosion. Herein, we examine and report a case of CSF otorrhea caused by arachnoid granulation. Literatures pertaining to the disorder will be reviewed and characteristics of the disorder also will be discussed.
Arachnoid ; Cerebrospinal Fluid Otorrhea ; Cholesteatoma ; Ear, Middle ; Granulation Tissue ; Rare Diseases

OBJECTIVE: To improve the possibility of diagnosis of the Mondini dysplasia. METHOD: The clinical manifestation and the examination of CT and MRI and surgical treatment of the Mondini dysplasia were discussed. RESULT: Because Mondini dysplasia with cerebrospinal fluid leak would occur recurrent meningitis, the patients were often difficult to be diagnosed. Especially. if the defect was unilateral, it was frequently unrecognized. CONCLUSION The patients with recurrently unclear cerebrospinal fluid leak and meningitis would be suspected. The diagnosis of the disease is based on the examination of the temporal bone CT and MRI. To the patients with cerebrospinal fluid leak, a transtympanic closure is one of very effective management.
Adolescent ; Cerebrospinal Fluid Otorrhea ; diagnosis ; etiology ; surgery ; Ear, Inner ; abnormalities ; Humans ; Male ; Tympanoplasty ; methods

OBJECTIVETo review the clinical characteristics of spontaneous intracranial hypotension (SIH) with cerebrospinal fluid (CSF) leakage.

METHODSClinical data of 42 SIH patients with cerebrospinal leakage, whose diagnosis met the criteria of the International Headache Classification, were retrospectively reviewed. The patients were divided into short (n=27) and long (n=15) course groups. The clinical data and imaging features were compared between two groups.

RESULTSThirty-nine patients (92.9%) had orthostatic headache. Compared with the short course group, the frequency of headache were significantly lower in patients with long disease duration (80% vs 100%, P =0.040); the ratio of high CSF opening pressure (>=60.0 mm H2O), the average CSF opening pressure, and the frequencies of subdural hematoma were higher in long course group than those in short course group [60.0% vs 20.8%, (64.7±42.1) vs (40.0±33.8)mm H2O, and 50.0% vs 11.6%; P=0.019, 0.038 and 0.018, respectively]. Forty-two patients underwent CT myelography;definite focal CSF leakage sites were found in all patients and multiple sites of CSF leakage in 38 patients.

CONCLUSIONAll SIH do not necessarily show the typical clinical manifestations, and cranial MRI and CT myelography are helpful in the diagnosis. Because of higher risk of subdural hemorrhage, patients with long disease duration require active intervention.

Adolescent ; Adult ; Aged ; Cerebrospinal Fluid Otorrhea ; complications ; Cerebrospinal Fluid Rhinorrhea ; complications ; Female ; Humans ; Intracranial Hypotension ; diagnosis ; etiology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Brain tissue herniation into the mastoid cavity is an uncommon phenomenon: nevertheless, it has been described since the earliest years of this century. Serious sequelae and central nervous system infection may result from inadequate management, but it has become relatively rare with improved antibiotic treatment and surgical technique. It might be caused by chronic otitis media, previous ear surgery, trauma and neoplasm, or spontaneously. Spontaneous brain herniation is extremely rare. It gives rise to cerebrospinal fluid otorrhea, progressive hearing loss, meningitis and other neurologic symptoms. Treatment depends on site and size of dura defect. We experienced one case of spontaneous brain herniation into the mastoid cavity, which we treated with surgery.
Brain* ; Central Nervous System Infections ; Cerebrospinal Fluid Otorrhea ; Ear ; Hearing Loss ; Hernia* ; Mastoid* ; Meningitis ; Neurologic Manifestations ; Otitis Media

Brain herniation into the middle ear cavity is a rare entity that occurs mostly as a complication of otologic surgery. Other causes include a congenital skull base defect, infection, trauma, neoplasm and irradiation. It gives rise to cerebrospinal fluid otorrhea, progressive hearing loss, tinnitus, meningitis and other neurologic symptoms. Such patients tend to be misdiagnosed as having chronic otitis media and are often treated for long periods with inadequate conservative therapy. We report a case of brain herniation into the middle ear following traumatic temporal bone fracture, which was treated surgically via a transmastoid approach.
Brain ; Cerebrospinal Fluid Otorrhea ; Cholesteatoma ; Ear, Middle ; Hearing Loss ; Humans ; Meningitis ; Neurologic Manifestations ; Otitis Media ; Skull Base ; Temporal Bone ; Tinnitus