A 32-year-old female presented with a watery discharge from her left ear for 40 days. She had a history of an accidental fall from a motorcycle 3 years prior that resulted in bleeding from her ear for 10 days. Examination found a small polypoid mass in her ear canal that was releasing clear fluid. Testing confirmed the fluid was cerebrospinal fluid (CSF). A CT-MR scan showed a bony dehiscence in the tegmen tympani with a prolapsed meningocele. The CSF leak was repaired through a trans canal trans mastoid approach using fat, cartilage, and fascia.

1. Post traumatic Delayed CSF Otorrhoea
Dr Shrikant Phatak
Head of ENT Department
Choithram Hospital & Research Center
Indore

2. Post traumatic Delayed CSF Otorrhoea
• 32 years old female presented with watery discharge
left ear since 40 days .She has taken Diamox 250mg
TDS for 1 month.
• There was a past history of accidental fall from
motorcycle 3 years back. She had ear bleed that time
which lasted for 10 days .
• Ear showed a small polypoid mass arising from the
roof of left external auditory canal.
• Clear watery fluid from around the mass in the ear
canal

3. Post traumatic Delayed CSF Otorrhoea
• Audiometry showed left ear 45 db conductive
deafness.
• Biochemical Examination of the fluid
confirmed to be CSF.
• CT-MR combo study of the temporal bone was
done.

4. Post traumatic Delayed CSF
Otorrhoea
Bony dehiscence in the tegmen
tympani(yellow) Prolapsed meningocele (Red)

5. Post traumatic Delayed CSF Otorrhoea

6. Post traumatic Delayed CSF Otorrhoea
• The leak was repaired by trans canal trans
mastoid approach using fat, conchal
cartilage,& temporalis fascia .

7. Post traumatic Delayed CSF Otorrhoea
• Thank you

8. Disclaimer
• The information contained in the presentation is based on the personal
experience and cases collected at Choithram Hospital Indore over the last
20 years.
• It is intended for the use of Medical students ENT post graduates.
• The views expressed are purely on personal opinion. viewers can make
their own opinion. For any confusion please contact sole author.
• Everybody is allowed to copy or download the material best suited to him.
I am not responsible for any controversies arising out of the presentation.
• For any suggestions or corrections you may please contact
phatak_shrikant@yahoo.in