Differentiation between CSF Otorrhea and Rhinorrhea in an Obscure Case of Recurrent Meningitis

Leakage of cerebrospinal fluid in the skull base may be accompanied with recurrent meningitis. The site of leakage may either be anterior (in the nose and paranasal sinuses) or posterior (in the temporal bone). Various imaging techniques can be used to precisely locate the point of leakage but despite all the advances in imaging techniques there are still some rare cases in which the surgeon can't be sure on the management approach before the beginning of surgery.

In this article we present one of these cases; we used intrathecal fluorescein to locate the source of the leak and made the final decision on the operating table.

Intrathecal fluorescein is helpful in locating the leakage in the ear or the nose in ambiguous cases.