CEREBROSPINAL FLUID OTORRHEA - NEW TRENDS IN DIAGNOSIS

C. Meco, G. Oberascher, K. Albegger

Department of Otolaryngology, LKA Salzburg

Salzburg / Austria

Cerebrospinal fluid (CSF) otorrhea or pseudo-CSF rhinorrhea are the result of a dural tear and CSF leakage in the tympanomastoid space and may be caused by base of skull fractures, tumors, infections, congenital anomalies, operative trauma, and missile wounds of the brain. The most common cause of CSF otorrhea are fractures of the temporal bone. With a tear in the dura, communication is created between the subarachnoid space and the otomastoid cavity. Meningitis and brain abcess can be possible complications.

During the past decades many methods were developed for diagnosing CSF. In our hands and our experience two methods have proven to be of greatest benefit. The first, a non invasive method and the golden standart, is the ß₂-transferrin test. The second method, indicated in only special cases, is the sodium fluorescein test (endoscopic and laboratory test). 1 ml 5% sodium fluorescein is applied by lumbar sites. In this paper we report about our experience and case material of the last 12 years ( >2000 ß₂-transferrin and > 500 sodium fluorescein tests).