Transcanal Endoscopic Management of Cerebrospinal Fluid Otorrhea Secondary to Congenital Inner Ear Malformations

Objective: To describe the feasibility of using a transcanal endoscopic approach for management of cerebrospinal leaks secondary to congenital inner ear malformations. Patients: Two pediatric patients with congenital inner ear malformations and concurrent cerebrospinal fluid leakage. Intervention: A stapedectomy was performed and the inner ear was packed with temporalis muscle using a transcanal endoscopic approach. Main Outcome Measure: Cessation of cerebrospinal fluid leakage from the inner ear to the middle ear. Results: An otic capsule malformation with a modiolar defect as well as a defect in the stapes footplate was noted in both patients. Successful repair of cerebrospinal fluid otorrhea was achieved in both patients using a minimally invasive transcanal endoscopic approach. One patient developed postoperative meningitis that was successfully managed with antibiotics. Conclusions: Cerebrospinal fluid otorrhea from an inner ear malformation often presents as persistent clear otorrhea after tympanostomy tube placement or recurrent meningitis as was the case in the two patients in this series. A minimally invasive transcanal endoscopic approach is a viable alternative to manage this unique entity.

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