title: Spontaneous bilateral and concurrent cerebrospinal fluid otorrhoea: case presentation and literature review.
abstract: BACKGROUND
  Cerebrospinal fluid otorrhoea is a rare entity. Only a few cases of spontaneous bilateral cerebrospinal fluid otorrhoea have been reported. In all cases, there was a definite time interval between the two (left and right) presentations.
  
  
  OBJECTIVE
  To raise awareness and report on the very rare entity of bilateral spontaneous cerebrospinal fluid otorrhoea.
  
  
  METHODS
  This paper reports the case of a bilateral, synchronous, spontaneous cerebrospinal fluid otorrhoea in a 44-year-old female. The patient had grommets surgically inserted on two separate occasions for treatment of otitis media with effusion, and received several courses of oral and topical antibiotics. Five years following the patient's initial presentation, a suspicion of concurrent bilateral cerebrospinal fluid otorrhoea was raised. The otorrhoea sample collected proved to be cerebrospinal fluid. Cross-sectional imaging revealed bilateral defects in the tegmen tympani of the skull base. She underwent staged middle fossa craniotomies to repair the defects.
  
  
  CONCLUSIONS
  Careful observation of the middle-ear fluid characteristics following myringotomy can allow for prompt diagnosis.
authors.affiliation: Department of ENT,New Cross Hospital,Royal Wolverhampton Hospitals NHS Trust,UK.
authors.forename: T
authors.initials: T
authors.lastname: Tikka
authors.affiliation: Department of ENT,Queen Elizabeth Hospital,University Hospitals Birmingham NHS Foundation Trust,UK.
authors.forename: A
authors.initials: A
authors.lastname: Opeodu
authors.affiliation: Department of ENT,Queen Elizabeth Hospital,University Hospitals Birmingham NHS Foundation Trust,UK.
authors.forename: R
authors.initials: R
authors.lastname: Irving
authors.affiliation: Department of ENT,New Cross Hospital,Royal Wolverhampton Hospitals NHS Trust,UK.
authors.forename: J
authors.initials: J
authors.lastname: Murphy
mesh_terms: D000328:Adult; D002558:Cerebrospinal Fluid Otorrhea / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008876:Middle Ear Ventilation / Q000379:methods; D010034:Otitis Media with Effusion / Q000150:complications / Q000601:surgery
keywords: Cerebrospinal Fluid; Otorrhea; Spontaneous