[Congenital CSF otitic leakage presenting as rhinorrhea: report of a case]

A 10-year-old girl was brought to our ear, nose and throat clinic for consultation on her articulation problem in addition to an attack of bacterial meningitis and cerebrospinal fluid (CSF) rhinorrhea. These problems had bothered her and her family for about 5 years. In August 1988, she had received a bifrontal osteoplastic craniotomy for her CSF leakage, but the procedure was ineffective. Local examination showed bilaterally intact ear drums. The left ear drum looked cloudy and thick with poor mobility under pneumatoscopy. A tympanogram showed that B type. Pure tone audiometry revealed a profound sensorineural hearing loss in the left ear. A CT scan showed widening of the internal auditory canal and dysplasia of the left cochlea and vestibule in addition to fluid accumulation in the mastoid and mesotympanum. Under the impression of CSF otorrhea, an exploratory tympanotomy was performed, revealing an area of leakage in the tympanic cavity. It was sealed with abdominal fat, temporal connective tissue and tissue glue. All of the bothersome symptoms disappeared postoperatively during an 18-month follow-up.