Imaging of the Hyrtl Fissure: A Rare Cause of Congenital CSF Otorrhea

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Updated: Jun 19, 2026

State of the Art Cranial Ultrasound Imaging in Neonates
10:02

State of the Art Cranial Ultrasound Imaging in Neonates

Published on: February 2, 2015

24.1K

Jamie E Clarke1, John Manov1, Josephine M Ndolo2

  • 1From the Department of Radiology (J.E.C., J.M., G.S.), Jackson Memorial Hospital, Miami, Florida.

AJNR. American Journal of Neuroradiology
|February 27, 2025
PubMed

Insights

Hyrtl fissure, a rare congenital condition, can cause cerebrospinal fluid (CSF) leakage from the ear in infants. Early diagnosis is crucial to prevent recurrent ear and brain infections.

Area of Science:

  • Otolaryngology
  • Pediatric Neurology
  • Medical Imaging

Background:

  • Hyrtl fissure is a rare congenital anomaly.
  • It can lead to cerebrospinal fluid (CSF) otorrhea in infants.
  • This condition predisposes infants to recurrent ear and intracranial infections.

Purpose of the Study:

  • To describe three cases of Hyrtl fissure.
  • To focus on the embryologic basis of the condition.
  • To highlight the conventional and advanced imaging features.

Main Methods:

  • Case series presentation.
  • Review of embryologic development.
  • Analysis of imaging findings (conventional and advanced).

Main Results:

  • Three cases of Hyrtl fissure with CSF otorrhea were identified.
  • The embryologic origin of the anomaly was discussed.
  • Characteristic imaging features were presented.

Conclusions:

  • Hyrtl fissure is a critical diagnosis in infants with recurrent meningitis or otitis media.
  • Identification is vital for appropriate management and prevention of infections.
  • Imaging plays a key role in diagnosing this rare bony anomaly.

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