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Spontaneous resolution of cerebrospinal fluid otorrhoea in a patient with a Hyrtl's fissure

Published online by Cambridge University Press:  05 August 2015

R Brar ,
A Vijendren ,
M Salam  and
G Picken
R Brar*
Affiliation:
Department of ENT, Ipswich Hospital Trust, UK
A Vijendren
Affiliation:
Department of ENT, Ipswich Hospital Trust, UK
M Salam
Affiliation:
Department of ENT, Ipswich Hospital Trust, UK
G Picken
Affiliation:
Department of Radiology, Ipswich Hospital Trust, UK
*
Address for correspondence: Dr Ravinder Brar, Department of ENT, Ipswich Hospital Trust, Heath Road, Ipswich IP4 5PD, UK E-mail: Rav.brar86@gmail.com
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Abstract

Objective:

This paper reports a rare case of cerebrospinal fluid leak due to a Hyrtl's fissure and discusses the non-operative management of the case.

Background and case report:

Cerebrospinal fluid otorrhoea is a rare phenomenon arising from an abnormal communicating tract between the subarachnoid space and middle ear. Affected patients are at a higher risk of developing meningitis and other neuro-otological complications. There are four common congenital causes of cerebrospinal fluid otorrhoea in the region of a normal labyrinth. This paper describes a case of cerebrospinal fluid in the middle ear resulting from a Hyrtl's fissure, which resolved spontaneously.

Conclusion:

A literature search indicated this to be the first case with such a resolution without the need for any intervention.

Keywords

Congenital FissureCerebrospinal Fluid OtorrheaEar Diseases
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 8 , August 2015 , pp. 817 - 819
Copyright
Copyright © JLO (1984) Limited 2015 

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References

1Medscape. CSF otorrhea. In: http://emedicine.medscape.com/article/883160-overview [22 July 2014]Google Scholar
2Pachauri, R, Nagasonkar, S, Kirtane, MV. Spontaneous CSF otorrhoea – presenting as conductive deafness. Indian J Otolaryngol Head Neck Surg 2002;54:51–4CrossRefGoogle ScholarPubMed
3Brown, NE, Grundfast, KM, Jabre, A, Megerian, CA, O'Malley, BW Jr, Rosenberg, SI. Diagnosis and management of spontaneous cerebrospinal fluid-middle ear effusion and otorrhea. Laryngoscope 2004;114:800–5CrossRefGoogle ScholarPubMed
4Savva, A, Taylor, MJ, Beatty, CW. Management of cerebrospinal fluid leaks involving the temporal bone: report on 92 patients. Laryngoscope 2003;113:50–6CrossRefGoogle ScholarPubMed
5Gacek, RR, Leipzig, B. Congenital cerebrospinal otorrhea. Ann Otol Rhinol Laryngol 1979;88:358–65CrossRefGoogle ScholarPubMed
6Gacek, RR, Gacek, MR, Tart, R. Adult spontaneous cerebrospinal fluid otorrhea: diagnosis and management. Am J Otol 1999;20:770–6Google ScholarPubMed
7Jegoux, F, Malard, O, Gayet-Delacroix, M, Bordure, P, Legent, F, Beauvillain de Montreuil, C. Hyrtl's fissure: a case of spontaneous cerebrospinal fluid. AJNR Am J Neuroradiol 2005;26:963–6Google ScholarPubMed
8Rich, PM, Graham, J, Phelps, PD. Hyrtl's fissure. Otol Neurotol 2002;24:476–82CrossRefGoogle Scholar
9Mouzali, A, Ouennoughi, K, Haraoubia, MS, Zemirli, O, Triglia, JM. Cochlear implant electrode array misplaced in Hyrtl's fissure. Int J Pediatr Otorhinolaryngol 2011;75:1459–62CrossRefGoogle ScholarPubMed
10Spector, GJ, Lee, D, Carr, C, Davis, G, Schnettgoecke, V, Strauss, M et al. Later stages of development of the periotic duct and its adjacent area in the human fetus. Laryngoscope 1980;90:1–31CrossRefGoogle ScholarPubMed
11Levenson, MJ, Desloge, RB, Parisier, SC. Beta-2 transferrin: limitations of use as a clinical marker for perilymph. Laryngoscope 1996;106:159–61CrossRefGoogle ScholarPubMed
12Kutz, JW, Husain, IA, Isaacson, B, Roland, PS. Management of spontaneous cerebrospinal fluid otorrhea. Laryngoscope 2008;118:2195–9CrossRefGoogle ScholarPubMed
13Kveton, JF, Goravalingappa, R. Elimination of temporal bone cerebrospinal fluid otorrhea using hydroxyapatite cement. Laryngoscope 2000;110:1655–9CrossRefGoogle ScholarPubMed