Otorrhee spontanee de liquide cephalorachidien: revue de la litterature a propos d'un cas

摘要

Cerebrospinal fluid otorrhoea may occur through the temporal bone both in children and adults. In children it is generally associated with labyrinthine malformations and usually presents withhearing loss in a child with recurrent meningitis. In adults it is sequel to direct head injury, ototogic or neurotologic surgery or infection. More rarely this pathology is described as being "spontaneous", ocurring without any history of trauma, surgery or infection. Spontaneous cerebrospinal fluid otorrhoea in adults may present with dull symptoms such as a blocked ear or short term conductive hearing-loss. The anatomic she, of this fistula is the tegmem tympani which may have a microscopic or macroscopic bone deficiency or sometimes even a "silent" meningoencephalic herniation. The authors describe a case of spontaneous cerebrospinal fluid otorrhoea occuring in an adult patient with bilateral abscence of the tegmen tympani and review the literature regarding this specific. They suggest that its actual occurence may be underestimated. Special attention should be given to adult patients with recurrent or persistent middle ear effusion. Any suspicion should be followed by meticulous imaging and surgical exploration since this may be a lifethreatning situation.