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Web md cerebrospinal fluid leak12/8/2023 ![]() Our patient presented with a type I leak that occurred through a congenital inner ear malformation.Ĭongenital malformations of the inner ear can be classified as described by Jackler et al. Type I leaks occur through the inner ear due to an inner ear abnormality type II leaks typically occur through congenital dehiscence that presents adjacent to a normal inner ear and type III leaks often occur due to intracranial hypertension. Neely classified spontaneous CSF middle effusions into 3 types, depending on whether they occur through, adjacent, or distal to the otic capsule. Therefore, CSF leaks can often be overlooked for long periods of time. Sometimes, patients may present with symptoms of meningitis, recurrent meningitis, or hearing loss. The symptoms of CSF leak are often nonspecific, such as ear fullness, tinnitus, headache, vertigo, rhinorrhea, or otorrhea. 6 months after surgery, rhinorrhea in this patient was resolved, the MRI was performed again which revealed no fluid collection in the right middle ear and mastoid area.Ī CSF leak can occur following trauma or surgery but rarely occurs spontaneously. This patient was treated for hearing impairment by cochlear implants. There were no intra- and post-operative complications. Several pieces of the temporal muscle and fascia straps were used to stop the CSF leakage. This patient underwent surgery, and CSF leakage was confirmed intra-operatively. Magnetic resonance imaging (MRI) scans revealed that the seventh and eighth cranial nerves were present ( Fig. 2). Because inner ear anomalies are often associated with cerebrospinal fluid leaks, this finding combined with the clinical symptoms led to the suspicion of CSF leakage from the right ear. This anomaly was classified as cochlear hypoplasia type III (CH-III, cochleae with fewer than 2 turns) as described by Sennaroglu et al. The superior semicircular canal was observed, but the posterior and lateral semicircular canal were hypoplastic ( Fig. 1). Bilateral IEMs, including cochleae with fewer than 2 turns, were detected. Computed tomography (CT) scanning of the temporal bones revealed the accumulation of fluid in the right middle ear and mastoid area. This patient had no previous history of ear infections and no signs of meningitis. ![]() ![]() According to the parents, the patient had exhibited a poor response to sound starting at 6 months of age. ![]() This patient had previously been diagnosed with upper respiratory tract infections several times. These symptoms were discovered after birth. A 12-month-old girl presented to the hospital due to intermittent rhinorrhea from the right nostril, and the fluid was opaque and clear. ![]()
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