Abstract:ObjectiveTo study the clinical features and treatment of spontaneous cerebrospinal fluid otorrhea.MethodsClinical data of 4 patients suffering from spontaneous cerebrospinal fluid otorrhea surgically treated in our department between July 2015 and Dec. 2016 were analyzed retrospectively.ResultsAll the 4 patients had a history of bacterial meningitis. Of them, 2 patients had inner ear malformation (incomplete partition type I) with round defect on stapedial footplate and 2 had posterior fossa bone defect with conductive hearing loss. The two patients with inner ear malformation underwent exploratory tympanotomy, during which the cerebrospinal fluid was pulsated from the defect of the stapedial footplates. Incus and stapes were removed, and the vestibular windows were sealed with temporalis fascia, auricle cartilage and fibrin glue. The other two patients with posterior fossa bone defect underwent simple mastoidectomy to expose the bone defects which were sealed with temporalis fascia, auricle cartilage, bone dust and fibrin glue. All patients were followed up for 23 to 39 months without recurrence of cerebrospinal fluid otorrhea and meningitis.ConclusionWith low morbidity, spontaneous cerebrospinal fluid otorrhea is easy to be missed and misdiagnosed, resulting in recurrent meningitis. The possibility of spontaneous cerebrospinal fluid otorrhea should be highly suspected in patients with hearing loss associated with meningitis.
