CSF otorrhea

Introduction

leakage of CSF from the ear

Etiology

• complication of acoustic neuroma surgery
• middle ear surgery
• cholesteatoma
• congenital anomalies in the formation of the inner ear & mastoid
• trauma or surgery disrupting the tympanic membrane
  • tympanostomy

Epidemiology

rare

Pathology

• occurs only with perforation in the tympanic membrane or a defect in the external ear canal
• otherwise, CSF flows down the eustachian tube & presents as CSF rhinorrhea

Laboratory

• body fluid glucose (low if due to nasal secretion)
• beta-2 transferrin in body fluid
• see CSF leakage

Complications

• meningitis

Management

• prophylactic antibiotics controversial
• spontaneous CSF otorrhea
  • surgical repair determined by the nature & location of the defect
• postsurgical & traumatic leaks
  • surgery is reserved for those in whom conservative therapy is unsuccessful
  • furosemide, hydrochlorothiazide, or acetazolamide may decrease production of CSF
  • compressive dressing & bed rest with head elevation
  • continuous lumbar spinal fluid drainage may be useful to reduce CSF pressure

More general terms

• cerebrospinal fluid (CSF) leakage
• otorrhea