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Published on: February 29, 2020
Diagnosis and management of spontaneous CSF otorrhea associated with skull base defects
Shaohua Wu1, Lang Xu2, Shuo Liu3
1Department of Otolaryngology-Head and Neck Surgery, The 6th Medical Center of Chinese PLA General Hospital, Beijing, China; National Clinical Research Center for Otorhinolaryngologic Disease, Chinese PLA General Hospital, Beijing, China; Department of Otolaryngology-Head and Neck Surgery, West China Second University Hospital, Chengdu, Sichuan University, China.
Objective:
This study aimed to characterize spontaneous CSF otorrhea or otorhinorrhea from skull base defects, including its clinical presentation, management outcomes, and causes of recurrence.
Methods:
A retrospective cohort study was performed on 20 patients who underwent surgical repair at Chinese PLA General Hospital between 2009 and 2024.
Results:
The cohort was predominantly adult (75%), male, and right-sided. Key presentations were conductive hearing loss (85%), otorrhea (50%), and meningitis (35%). Most defects (85%) involved the middle cranial fossa floor. Initial surgical success was 75%, with recurrence (mean 3.78 months) attributed to inadequate obliteration, recanalization, or missed defects. Notable complications included intracranial hypertension and facial paralysis.
Conclusion:
Spontaneous CSF otorrhea or otorhinorrhea typically originates from the middle cranial fossa floor in adults. While multi-layered surgical repair is effective, its success can be compromised by technical factors, underscoring the necessity of meticulous preoperative assessment to reduce recurrence.
