Spontaneous CSF Otorrhea Masquerading as Middle Ear Effusion: A Case Report

Spontaneous cerebrospinal fluid (CSF) otorrhea is a rare but important differentialdiagnosis in cases of persistent middle ear effusion. We report a case of a 45-year-old female who presented with persistent aural fullness and hearing loss in theright ear immediately following an airplane flight. She was initially diagnosed withmiddle ear effusion and underwent myringotomy with grommet ventilation tubeinsertion. However, the patient continued to experience profuse watery otorrheafor two months postoperatively. Subsequent computed tomography of the temporalbone confirmed a CSF leak from a defect in the tegmen tympani near the anteriorepitympanum. The patient underwent successful endoscopic CSF otorrhea repairunder general anaesthesia. Three months postoperatively, the patient’s hearingimproved, and her aural symptoms resolved. This case highlights the importance ofconsidering spontaneous CSF leaks in cases of sudden-onset conductive hearing loss,even in the absence of trauma or prior surgical history.