EIGHT PATIENTS with persistent cerebrospinal fluid (CSF) otorrhea were seen at the Mayo Clinic during the years 1955 through 1965. Two of these patients had complicated problems of diagnosis and treatment, and their cases will be reported in detail.
A CSF fistula is a nuisance to the patient, with liquid dripping from the ear or through the eustachian tube and out of the nose. Of more importance, however, is that such a fistula serves as a route for bacterial invasion. Meningitis or intracranial abscess is to be expected in any patient with persistent CSF otorrhea. For this reason Dandy,1 in 1944, advocated surgical repair of any CSF fistula within two weeks after its onset.
Cerebrospinal fluid otorrhea is caused most often by skull fracture, and is looked for routinely in patients who have had trauma to the head. If present, such otorrhea is presumptive evidence of a temporal bone