2025 Volume 35 Issue 1 Pages 42-50
We report the case of a 55-year-old man with spontaneous cerebrospinal fluid (CSF) otorrhea, diagnosed based on the detection of glucose in the otorrhea. Computed tomography (CT) revealed a bony defect located on the floor of the middle cranial fossa above the anterior tympanum.
Surgical treatment was performed using a transmastoid approach, and the anterior tympanic space was opened. Membranous tissue matching the bone defect on CT was found on the anterior roof of the space. After removal of this tissue, a dural defect with a 3 × 3-mm and a CSF leak were confirmed. The CSF leak was repaired by plugging the defect with a free fascia and was further reinforced with a pedicled galea flap. One year after the surgery, no recurrence was observed.
In this case, CT images were examined before surgery. CT images taken 5 years and 10 months before surgery did not show bone resorption in the anterior tympanic cavity. However, CT images taken 2 years and 2 months ago showed slight bone absorption and soft tissue shadows in the anterior tympanic air cell. Thus, it was inferred that signs of onset existed from this period.
