Spontaneous Cerebrospinal Fluid Otorrhea in association with an Aqueductal Stenosis

Abstract

A case of adult aqueductal stenosis presenting with cerebrospinal fluid (CSF) otorrhea is reported. The patient, a 56-year-old female, was admitted because of CSF otorrhea which had appeared spontaneously for the previous 2 months. Neurological examination on admission revealed bilateral optic atrophy and left conductive deafness. CSF leakage from the left Eustachian tube was confirmed by nasopharyngeal fiberscopy. The skull X-ray and computed tomography (CT) scan were consistent with aqueductal stenosis. Metrizamide CT cisternography showed clouding of the left mastoid air cells and middle ear cavity, presumably due to overflowing of CSF. The patient was gradually relieved of CSF otorrhea after shunt insertion. Spontaneous CSF otorrhea is an uncommon phenomenon and has seldom been described in association with aqueductal stenosis. The authors review the literature and discuss the possible routes of CSF leakage and the treatment for this rare complication.