Cano BMF, Espino ML

Language: Spanish
References: 5
Page: 41-47
PDF size: 264.46 Kb.

ABSTRACT

Background: Cerebrospinal fluid fistulas in the ear are a rare condition, which can be congenital or acquired, with the most common causes being trauma, surgery, or, more rarely, spontaneous occurrences. Risk factors include body mass index, increased intracranial pressure, and obstructive sleep apnea. The diagnosis is primarily clinical and can be confirmed through imaging studies, such as simple tomography and magnetic resonance imaging. Additional diagnostic tests include biochemical analysis for β2-transferrin protein or traces of β2-transferrin. While medical management can be considered, the treatment of choice is surgery, with various surgical approaches available.
Clinical case: A 54-year-old female patient with clear otorrhea and spontaneous hearing loss in the right ear. Physical examination confirmed cerebrospinal fluid leakage from the external auditory canal. A tomographic study revealed the dehiscence of the tegmen tympani, and medical management was initiated, along with surgical treatment to close the fistula via an endaural approach using an endoscope and a cartilage graft from the tragus, as well as fascia.
Conclusions: Cerebrospinal fluid fistulas are considered a medical emergency due to the risk of complications, such as meningitis, and thus require prompt evaluation and management.

REFERENCES

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