Abstract:Objective To analyze and explore the clinical characteristics, surgical methods and postoperative effect of spontaneous cerebrospinal fluid otorrhea (SCSFO).Methods Clinical data of 10 patients with SCSFO admitted to our department from 2015 to 2020 were retrospectively analyzed, and the clinical characteristics, imaging features, surgical methods, perioperative management, and postoperative follow-up results were summarized.Results Of all the cases, 6 were female and 4 male including 3 children and 7 adults. The disease history ranged from 25 days to more than 20 years. Nine cases were unilateral and one was bilateral. All the 3 children suffered from congenital severe sensorineural hearing loss, and were diagnosed with rhinorrhea or meningitis. Among the 7 adults, 5 cases suffered from ear fullness and hearing loss with accompanied otorrhea in one, one suffered from rhinorrhea and another one suffered from ear pain accompanied with meningitis. Four patients had past history of tympanocentesis or myringotomy with grommet insertion. The leak points were located at and around the stapedial foot plate in all the 3 children (4 ears) with stapes deformity in 2. Of the 7 adults, the leaks points were located at the stapedial foot plate in 2, tympanic tegmentum in 3 and mastoid tegmentum in 2. Postoperative epilepsy and increased intracranial pressure occurred in one case. All the patients were followed up for 5 months to 6 years, and there was no recurrence of cerebrospinal fluid otorrhea.Conclusions It is particularly important to identify the early symptoms, master the localization and qualitative diagnosis methods of SCSFO. Once diagnosed, surgical exploration is recommended due to poor conservative treatment outcome. Accurate localization of leak point and exact repair of leaks are essential.
