Related Experiment Video
Updated: May 17, 2026
06:59
Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
Published on: February 29, 2020
Spontaneous CSF otorrhoea - Presenting as conductive deafness.
Rajeev Pachauri1, Smita Nagaonkar, M V Kirtane
1Dept. of ENT & Head & Neck Surgery, P.D. Hinduja National Hospital & Medical Research Center, 1SI Floor, Old Building, Veer Savarkar Marg, Mahim, 400 016 Mumbai.
Summary
Spontaneous cerebrospinal fluid (CSF) otorrhea is rare, especially in older adults. This case highlights diagnosis and successful surgical repair of a rare spontaneous CSF leak, preventing recurrence.
Area of Science:
- Otolaryngology
- Neurosurgery
- Medical Diagnostics
Background:
- Spontaneous cerebrospinal fluid (CSF) otorrhea is uncommon, particularly in adults.
- Congenital inner ear malformations are a frequent cause in children, while adults may present with otorrhea following trauma or spontaneously.
- Typical presentations differ between age groups, with pediatric cases often linked to meningitis and adult cases showing watery nasal or ear discharge.
Purpose of the Study:
- To report a rare case of spontaneous CSF otorrhea in an adult.
- To illustrate the diagnostic process, including the use of B2-transferrin testing.
- To describe the successful surgical management and outcomes.
Main Methods:
- A case presentation of an adult patient with conductive deafness and negative middle ear pressure.
- Initial misdiagnosis as secretory otitis media, leading to grommet insertion.
- Confirmation of CSF otorrhea via B2-transferrin assay of middle ear fluid.
- Surgical intervention using a post-aural transmastoid approach to seal the defect.
Main Results:
- B2-transferrin levels confirmed the diagnosis of CSF otorrhea.
- Surgical repair of the dural defect was successfully performed in layers.
- The patient remained asymptomatic with no recurrence during follow-up.
Conclusions:
- Spontaneous CSF otorrhea requires a high index of suspicion for accurate diagnosis in adults.
- B2-transferrin testing is crucial for confirming CSF leaks.
- Surgical repair via a transmastoid approach is an effective treatment for spontaneous CSF otorrhea.
Related Concept Videos
01:16Anatomy of the Ear
Auditory sensation, commonly called hearing, involves the transformation of sonic waves into neural impulses facilitated by the structures of the auditory organ. The prominent, flesh-like structure on the side of the head, called the auricle, directs sound waves towards the auditory canal. The auricle is often mislabeled as the pinna, a term more aligned with mobile structures like a feline's external ear. The auditory canal penetrates the cranium via the external auditory meatus of the...
01:15Auditory Pathway
Auditory pathways constitute the complex neural circuits responsible for transmitting and interpreting auditory information from the peripheral auditory system to the brain. Sound waves are initially captured by the outer ear, funneled through the ear canal, and reach the tympanic membrane (eardrum). These vibrations are transmitted via the middle ear's ossicles to the inner ear's cochlea.
When viewed cross-sectionally, the cochlea reveals the scala vestibuli and scala tympani flanking the...
When viewed cross-sectionally, the cochlea reveals the scala vestibuli and scala tympani flanking the...
01:13The Cochlea
The cochlea is a coiled structure in the inner ear that contains hair cells—the sensory receptors of the auditory system. Sound waves are transmitted to the cochlea by small bones attached to the eardrum called the ossicles, which vibrate the oval window that leads to the inner ear. This causes fluid in the chambers of the cochlea to move, vibrating the basilar membrane.
01:26Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
01:31Hearing
When we hear a sound, our nervous system is detecting sound waves—pressure waves of mechanical energy traveling through a medium. The frequency of the wave is perceived as pitch, while the amplitude is perceived as loudness.