title: New considerations in the cause of spontaneous cerebrospinal fluid otorrhea.
abstract: OBJECTIVE
  To examine the demographic and radiographic features of patients with spontaneous cerebrospinal fluid otorrhea and to determine whether they display similar characteristics to patients with idiopathic intracranial hypertension.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Academic, tertiary referral center.
  
  
  METHODS
  All individuals presenting with spontaneous cerebrospinal fluid otorrhea, diagnosed between 2000 and 2009, undergoing primary surgical repair.
  
  
  METHODS
  All patients underwent surgical repair via a transmastoid, middle fossa, or combined transmastoid-middle fossa approach.
  
  
  METHODS
  Patient demographics such as age, race, sex, height, weight, and body mass index, the presence of a radiographically empty or partially empty sella, and preoperative radiographic and intraoperative surgical findings of the temporal bone.
  
  
  RESULTS
  Twenty-three patients underwent primary surgical repair for spontaneous cerebrospinal fluid otorrhea. Fifteen patients underwent preoperative magnetic resonance imaging of the head with 12 (80%) demonstrating the presence of an empty or partially empty sella. Mean body mass index of those patients with an empty or partially empty sella was 38.0 kg/m2 compared with 28.5 kg/m2 for those without an empty sella.
  
  
  CONCLUSIONS
  Patients with spontaneous cerebrospinal fluid otorrhea are often middle-aged and obese, with females being affected nearly twice as often as males. Empty or partially empty sella was observed in 80% of patients with spontaneous cerebrospinal fluid otorrhea as demonstrated by preoperative magnetic resonance imaging. Patients with spontaneous cerebrospinal fluid otorrhea who display these demographic and radiographic features should be further evaluated for the presence of idiopathic intracranial hypertension.
authors.affiliation: Medical University of South Carolina, Department of Otolaryngology-Head and Neck Surgery, Charleston, South Carolina, USA. jgoddard@hei.org
authors.forename: John C
authors.initials: JC
authors.lastname: Goddard
authors.forename: Ted
authors.initials: T
authors.lastname: Meyer
authors.forename: Shaun
authors.initials: S
authors.lastname: Nguyen
authors.forename: Paul R
authors.initials: PR
authors.lastname: Lambert
mesh_terms: D000328:Adult; D000368:Aged; D002558:Cerebrospinal Fluid Otorrhea / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D035301:Cranial Fossa, Middle / Q000601:surgery; D004652:Empty Sella Syndrome / Q000150:complications; D004677:Encephalocele / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008588:Meningocele / Q000150:complications / Q000601:surgery; D008875:Middle Aged; D013506:Otologic Surgical Procedures; D011559:Pseudotumor Cerebri / Q000150:complications / Q000453:epidemiology; D012189:Retrospective Studies; D013701:Temporal Bone / Q000002:abnormalities / Q000473:pathology; D014057:Tomography, X-Ray Computed