CASE REPORT Recurrent meningitis due to spontaneous cerebrospinal fluid otorrhea in adults

Spontaneous cerebrospinal fluid (CSF) fistula in congenital malformations of the inner ear is rare, and it is found most commonly in infants and children with impaired hearing. Spontaneous CSF otorrhea in adults is often due to defects in the tegmen and the bone overlying the posterior fossa in an otherwise normal ear. In the literature, there are few reports of adultonset spontaneous CSF otorrhea in congenital inner ear malformations. In this article, we report on an adult case with pediatric-pattern presentation. A 27-year-old patient with congenital hearing loss was referred to our center because of recurrent meningitis. Computed tomography scan revealed an inner ear anomaly, and surgical exploration found an oval window. The fistula was successfully closed using a minimally invasive nonablative technique with a muscle plug that did not violate inner ear structures. Department of Otolaryngology, Tehran University of Medical Sciences, Tehran, Iran