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CSF otorrhea
leakage of CSF from the ear
Etiology:
- complication of acoustic neuroma surgery
- middle ear surgery
- cholesteatoma
- congenital anomalies in the formation of the inner ear & mastoid
- trauma or surgery disrupting the tympanic membrane
- tympanostomy
Epidemiology: rare
Pathology:
- occurs only with perforation in the tympanic membrane or a defect in the external ear canal
- otherwise, CSF flows down the eustachian tube & presents as CSF rhinorrhea
Complications:
- meningitis
Laboratory:
- body fluid glucose (low if due to nasal secretion)
- beta-2 transferrin in body fluid
- see CSF leakage
Management:
- prophylactic antibiotics controversial
- spontaneous CSF otorrhea
- surgical repair determined by the nature & location of the defect
- postsurgical & traumatic leaks
- surgery is reserved for those in whom conservative therapy is unsuccessful
- furosemide, hydrochlorothiazide, or acetazolamide may decrease production of CSF
- compressive dressing & bed rest with head elevation
- continuous lumbar spinal fluid drainage may be useful to reduce CSF pressure
General
cerebrospinal fluid (CSF) leakage
otorrhea
References
- Hanson MD and Meyers AD
eMedicine: CSF otorrhea
http://emedicine.medscape.com/article/883160-overview