Temporal bone fracture and cerebrospinal fluid otorrhea: The role of acetazolamide

Breach in the leptomeninges of the temporal bone may lead to leakage of cerebrospinal fluid (CSF) from the subarachnoid space and present as CSF otorrhea. Traumatic CSF otorrhea is one of the most troublesome conditions associated with head trauma. Persistent CSF fistula, meningitis, or even death may complicate it. We present a 38-year-old male who sustained left CSF otorrhea secondary to head trauma following an accidental fall. High-resolution computed tomography revealed a complex comminuted fracture at the left temporal bone extending from the mastoid part of the temporal bone until the petrous apex. He was managed conservatively and had a resolution of the leakage after 5 days of injury. We report this case to uphold the role of acetazolamide as part of the conservative management in traumatic CSF otorrhea.