Description
Spontaneous cerebrospinal fluid (CSF) leakage through
the temporal bone in adults is thought to be rare and
therefore misdiagnosis or failure to make an early diagnosis
is common. It is defined as one that has no identifiable cause
such as trauma, surgery, infection, neoplasia or congenital
abnormalities. Most commonly these defects occur in the
tegmen tympani or tegmen mastoideum and less commonly
in the posterior fossa plate. The meningeal defects are
either meningoencephalocoeles or simply holes in the dura.
Patients usually present in adulthood with aural fullness and
hearing loss and the most common signs are a clear middle
ear effusion and clear tympanostomy tube otorrhoea. In this
review of the literature we discuss the pathogenesis, natural
history, salient investigations and the surgical management
of the condition.
