Analysis and long-term outcomes of spontaneous cerebrospinal otorrhea repair via the middle cranial fossa approach.

Abstract

Background: The incidence of spontaneous CSF otorrhea is increasing and knowledge about treatment management is growing.

Objectives: To analyse the cases operated via the middle cranial fossa approach (MCFA) for spontaneous CSF otorrhea in our clinic and to evaluate the long-term surgical results in the light of the literature.

Methods: Demographic data, presenting complaints, complications, hearing outcomes, recurrence rates and long-term success of patients operated with MCFA between 2012 and 2022 in our tertiary care centre were evaluated.

Results: The mean age of the 12 patients who met the inclusion criteria was 58.3 ± 13.4 years. Hearing loss and ear fullness in five patients and persistent otorrhea after ventilation tube insertion in three patients were the most common symptoms. The mean body mass index (BMI) was 35.03 ± 3.39. More than one defect was detected in seven patients. No perioperative or postoperative complications were observed in any patient. The mean airway hearing threshold (ASH)±SD was 40.6 ± 13 preoperatively and 24.4 ± 6.3 postoperatively, a statistically significant decrease (p = 0.003). The mean follow-up period was 80.8 ± 32.5 months and no recurrence was observed in any patient.

Conclusion: Our experience and results support the use of MCFA in the repair of spontaneous CSF otorrhea as safe, highly successful, and beneficial.