Spontaneous cerebrospinal fluid otorrhea and rhinorrhea coexisting in a patient with meningitis

Congenital (spontaneous) cerebrospinal fluid fistulae are uncommon, potentially dangerous, pathological conditions. Most present in childhood with repeated bouts of meningitis, although presentation in adulthood with an asymptomatic nasal mass has been well documented. Radiologic work-up of the patient will usually reveal an abnormality in either the labyrinth or the base of the skull. A patient is presented who had both spontaneous cerebrospinal fluid otorrhea and rhinorrhea. Three anatomic defects were identified as potentially accountable: a round window fistula, a meningoencephalocele and an empty sella turcica.