Non-classical presentation of congenital cholesteatoma as cerebrospinal fluid rhinorrhea - Case report and systematic review of the literature

作者：Dzaman Karolina; Tomaszewska Malgorzata; Krzeski Antoni; Zagor Mariola^*

来源：Neurologia i Neurochirurgia Polska, 2015, 49(3): 183-188.

DOI：10.1016/j.pjnns.2015.04.004

• Otogenic rhinorrhea
• Cerebrospinal fluid leak
• Otorhinorrhea
• Congenital cholesteatoma

Objective: Congenital cholesteatoma (CC) becomes clinically apparent as a cholesteatoma usually during childhood. Nontraumatic otogenic cerebrospinal fluid (CSF) rhinorrhea with an intact tympanic membrane is a very rare symptom.
Methods: The review of recent literature and case report of the 60-year old patient a trumpeter presented with nontraumatic otogenic CSF rhinorrhea, intact tympanic membrane on microotoscopy, and besides colorless fluid in right nasal cavity, normal finding on nasal endoscopy examination.
Results: CSF rhinorrhea was caused by CC in the petrous bone apex. Early diagnosis was facilitated by computed tomography scanning. Complete cholesteatoma removal was accomplished using a middle fossa craniotomy and an open non-radical antromastoidectomy.
Conclusion: The diagnosis of otogenic cerebrospinal fluid (CSP) rhinorrhea is challenging and it can easily be misdiagnosed. Congenital cholesteatoma is a rare entity. We present a non-classical presentation of CC in an adult male, with a previously unreported symptom of CSF rhinorrhea. Symptomatic improvement occurred after surgical treatment of the disease.

• 出版日期2015