Diagnosis and treatment of occult cerebrospinal fluid otorrhea
Tsinghua University, China
: J Otol Rhinol
Objective: The purpose of this study is to investigate the diagnosis and surgical treatment of occult cerebrospinal fluid otorrhea including clinical manifestations, imaging features and surgical methods. Methods: A retrospective analysis of 25 cases of cerebrospinal fluid otorrhea misdiagnosed as meningitis in our department from 2007 to 2017 was analyzed including clinical manifestations, imaging examination and treatment. Results: There were 11 cases of cerebrospinal fluid otorrhea after trauma, 13 cases of congenital cerebrospinal fluid ear leakage and one case secondary to petrous bone cholesteatoma. The special clinical manifestations included recurrent otorrhea or rhinorrhea, fever, headache, unilateral deafness. All patients underwent radiological examinations including high resolution enhanced computed tomography (HRCT), CT cisternography and magnetic resonance imaging (MRI). Procedures for surgical repair included transmastoid approach (n=12), trans-vestibular (n=1) or trans-labyrhythine approach (n = 12). Conclusion: The diagnosis and treatment of occult cerebrospinal fluid otorrhea were challenging and easily misdiagnosed. The characteristic clinical manifestations may provide important diagnostic clues. Radiographic examination including HRCT and CT cisternography may provide very important clues. According to different causes, different surgical techniques were taken to achieve good therapeutic effect.
Yi Haijin has graduated from Peiking Union Medical College in 2006 and worked in Department of Neurosurgery Division 9, Otolaryngology Head Neck Surgery of Beijing Tiantan Hospital in China. In 2011-2013, he continued as Post-doctoral Fellow at Department of Otolaryngology Head Neck Surgery of General Hospital of PLA of China. Currently, he is working in Department of Otolaryngology Head and Neck Surgery of Beijing Tsinghua Changung Hospital, Tsinghua University as an Associate Professor. His majors include Neurotology and Lateral Skull Base Surgery, including Facial Nerve, Acoustic Neuroma, Cochlear Impalnts and Vertigo. He has published more than 30 articles as the first author including 14 articles of SCI and edited 4 monographs. He is currently the Reviewer and Editor of Chinese clinicians’ journal, the Editor of American Journal of cancer research, Reviewer of Acta Otorhinolaryngol.