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Neurosciences and Behavioral Health Center

CSF Otorrhea

CSF (spinal fluid) otorrhea is a condition in which spinal fluid drains from the ear. Patients with CSF otorrhea often have hearing loss in the affected ear. 

There is a bone called the tegmen ("roof") that separates the ear from the brain, and in rare instances, the bone can become very thin and wear away. The brain then can sink down into the ear cavity. If the protective lining of the brain (dura) also wears away, spinal fluid will leak down into the ear.


As the spinal fluid usually stays in the middle ear and causes ear fullness, pressure and hearing loss result. It's as if you’re in a barrel, underwater or in a tunnel.


This condition is often misdiagnosed early on. Your otolaryngologist may see fluid behind the eardrum and try to treat the middle ear fluid with medication, which will not improve your hearing.

Once you’re diagnosed, your doctor will order a CT scan of the temporal bone to identify the site of the leak and plan for surgery.

Treatment for CSF Otorrhea

Most of the time, this condition can be repaired, the leak stopped and symptoms relieved.

Treatment involves an operation to repair the hole in the dura (with soft tissue such as abdominal fat) and the hole in the tegmen (with the patient’s own bone). This can be done from below (a "transmastoid" approach) or from above (a "middle fossa" approach). Your surgeon will determine the type of surgical approach that is used. The size and location of the defect will affect the decision.


Call 800.362.2203.


Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.


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