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Spontaneous cerebrospinal fluid otorrhoea via oval window: an obscure cause of recurrent meningitis

Published online by Cambridge University Press:  08 March 2006

D.T.W. Teo
Affiliation:
Department of Otolaryngology, Head & Neck Surgery, Singapore General Hospital, Singapore
T.Y. Tan
Affiliation:
Department of Diagnostic Radiology, Changi General Hospital, Singapore
S.P. Eng
Affiliation:
Division of Otolaryngology, Changi General Hospital, Singapore.
Y.M. Chan
Affiliation:
Department of Otolaryngology, Head & Neck Surgery, Singapore General Hospital, Singapore

Abstract

Spontaneous cerebrospinal fluid (CSF) leak via the oval window is uncommon and can result in recurrent bacterial meningitis. Current understanding of spontaneous CSF otorrhoea is reviewed and a diagnostic algorithm is presented.

A seven-year-old boy presented with bilateral congenital deafness and recurrent meningitis. High-resolution computed tomography (HRCT) of the temporal bone showed a labyrinthine deformity and communication between the internal auditory canal (IAC) and the cochlea. Subtotal petrosectomy with closure of the external acoustic meatus and eustachian tube was performed. Post-operatively, the child had no further episodes of meningitis.

This rare and obscure cause of recurrent childhood meningitis requires a high index of suspicion and the use of diagnostic tools, especially HRCT.

Type
Research Article
Copyright
© 2004 Royal Society of Medicine Press

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