Simultaneous cerebrospinal fluid otorrhea and rhinorrhea as a cause of recurrent meningitis in a patient with cochlear dysplasia

Abstract

Inner ear dysplasia is a rare cause of cerebrospinal fluid otorhinorrhea and presents in a variety of ways, ranging from asymptomatic to recurrent bacterial meningitis. We describe a 6-year-old boy who presented with clear watery nasal discharge and recurrent bacterial meningitis. Magnetic resonance cisternogram showed cerebrospinal fluid leak through the cribriform plate of ethmoid. High-resolution computed tomographic scan of temporal bones confirmed the diagnosis of cochlear dysplasia, with cerebrospinal fluid leak coming through a defect near the oval window and through the eustachian tube orifice into the nose. Surgical closure of the defects was performed successfully. Conclusion: Recurrent meningitis in a child should be investigated for inner ear malformations. Awareness of this condition, a high index of suspicion and early imaging can prevent complications and give excellent results in these children.