Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Inner Ear Malformation Masquerading as CSF Rhinorrhea - New Perspectives of Management and Literature Review

Document Type : Case Report

Authors
Nidhin Das K 1
Vidhu Sharma 1
Sarbesh Tiwari 2
Amit Goyal 1
1 Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, India.
2 Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, India.
10.22038/ijorl.2023.70032.3385
Abstract
Introduction:
Spontaneous cerebrospinal fluid (CSF) rhinorrhea is rare and may develop secondary to inner ear malformation. A possible diagnosis of CSF leak should be considered in any Pediatric patient who presents with hearing impairment, rhinorrhea, or otorrhea.
Case Report:
We describe a case of 13 months male infant presenting with rhinorrhoea which on evaluation found to be CSF oto-rhinorrhoea due congenital inner ear malformation. Imaging showed malformed inner ear on both sides with CSF leak on left side with bilateral profound sensory neural hearing loss. A multidisciplinary management was considered. Child underwent CSF leak repair on left side followed by Cochlear implantation on right side in another setting.
Conclusion:
This case is a perfect example to describe the cumbersome management of CSF leak with inner ear anomaly addressing the auditory habilitation on the grounds of recent innovations. As per available literature inner ear anomaly is an important subgroup of population of cochlear implant candidates with promising auditory outcomes.
Keywords
Cochlear Implants
CSF leak
Inner ear malformation
Subjects

  1. References

    1. Sennaroğlu L, Bajin MD. Classification and current management of inner ear malformations. Balkan medical journal.2017 Sep 29;34(5):397-411.
    2. Sennaroglu L. Cochlear implantation in inner ear malformations–a review article. Cochlear implants international. 2009.
    3. Kraus M, Hassannia F, Bergin MJ, Al Zaabi K, Rutka JA. Long-term outcomes from blind sac closure of the external auditory canal: our institutional experience in different pathologies. The Journal of International Advanced Otology. 2020 Apr; 16(1):58.
    4. Sennaroglu L, Saatci I. A new classification for cochleovestibular malformations. The Laryngoscope. 2002 Dec;112(12):2230-41.
    5. Beltrame MA, Frau GN, Shanks M, Robinson P, Anderson I. Double posterior labyrinthotomy technique: results in three Med-El patients with common cavity. Otology & Neurotology. 2005 Mar 1; 26(2):177-82.
    6. Phelps PD, King A, Michaels L. Cochlear dysplasia and meningitis. The American journal of otology. 1994 Jul 1;15(4):551-7.
    7. Isaiah A, Lee D, Lenes-Voit F, Sweeney M, Kutz W, Isaacson B, Roland P, Lee KH. Clinical outcomes following cochlear implantation in children with inner ear anomalies. International journal of pediatric otorhinolaryngology. 2017 Feb 1; 93:1-6.
Iranian Journal of Otorhinolaryngology
Volume 35, Issue 4
July and August 2023
Pages 223-226