[Spontaneous otorrhea involving defects of the tegmentum tympani].

OBJECTIVE

We report two cases and a review of the literature concerning spontaneous otoliquorrhea involving congenital bone defects of the tegmen tympani.

CASE REPORTS

Both patients were managed by a cooperative otological and neurosurgical team. Otological symptoms predominated. The bilateral bone defects of the tegmen tympani were highlighted by high-resolution computed tomography. Surgery was undertaken via the middle fossa approach.

DISCUSSION

Spontaneous cerebrospinal fluid otorrhea related to tegmen tympani defects is rare. It occurs in adults with no previous otological history. The anomaly is congenital. Otological symptoms (differential diagnosis with serous media otitis) are usually predominant. Infectious meningitis may occur. The diagnosis is based on high resolution computed tomography and surgical treatment is required. Numerous technical approaches are possible (transmastoid and/or middle fossa approach) depending on the extent of the defect. Complete recovery is usual after adapted surgical treatment.