title: Bilateral spontaneous cerebrospinal fluid otorrhea.
abstract: We present a rare case of bilateral cerebrospinal fluid (CSF) otorrhea via multiple bony defects in the left tegmen and a single defect with the herniated brain tissue on the right side. Initially, the patient complained of left hearing loss and fullness and was diagnosed with serous otitis media. After myringotomy, the pulsating watery discharge suggested CSF otorrhea. Five months after surgical repair of the left side, right-side CSF leakage occurred. The right side was repaired surgically, and the patient recovered without incident. From our findings and a review of the literature, we postulate that bilateral CSF otorrhea resulted mainly from the thinness of the tegmen because of well-pneumatized mastoid air cells and the weakness of the dura after chronic inflammatory changes. In case of spontaneous CSF otorrhea, the roof of tegmen should be assessed bilaterally with care using radiologic examinations so as not to overlook a subclinical condition on the contralateral side.
authors.affiliation: Department of Otolaryngology, Ehime University School of Medicine, Onsen-gun, Japan. nobuhon@m.ehime-u.ac.jp
authors.forename: Nobumitsu
authors.initials: N
authors.lastname: Honda
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Okouchi
authors.forename: Hidemitsu
authors.initials: H
authors.lastname: Sato
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Sanuki
authors.forename: Naohito
authors.initials: N
authors.lastname: Hato
authors.forename: Naoaki
authors.initials: N
authors.lastname: Yanagihara
authors.forename: Shingo
authors.initials: S
authors.lastname: Murakami
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Gyo
mesh_terms: D002558:Cerebrospinal Fluid Otorrhea / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed