open access
Non-classical presentation of congenital cholesteatoma as cerebrospinal fluid rhinorrhea – Case report and systematic review of the literature
Affiliations- Department of Otolaryngology, Division of Dentistry, Medical University of Warsaw, Warsaw, Poland
open access
Abstract
Congenital cholesteatoma (CC) becomes clinically apparent as a cholesteatoma usually during childhood. Nontraumatic otogenic cerebrospinal fluid (CSF) rhinorrhea with an intact tympanic membrane is a very rare symptom.
MethodsThe review of recent literature and case report of the 60-year old patient – a trumpeter presented with nontraumatic otogenic CSF rhinorrhea, intact tympanic membrane on microotoscopy, and besides colorless fluid in right nasal cavity, normal finding on nasal endoscopy examination.
ResultsCSF rhinorrhea was caused by CC in the petrous bone apex. Early diagnosis was facilitated by computed tomography scanning. Complete cholesteatoma removal was accomplished using a middle fossa craniotomy and an open non-radical antromastoidectomy.
ConclusionThe diagnosis of otogenic cerebrospinal fluid (CSF) rhinorrhea is challenging and it can easily be misdiagnosed. Congenital cholesteatoma is a rare entity. We present a non-classical presentation of CC in an adult male, with a previously unreported symptom of CSF rhinorrhea. Symptomatic improvement occurred after surgical treatment of the disease.
Abstract
Congenital cholesteatoma (CC) becomes clinically apparent as a cholesteatoma usually during childhood. Nontraumatic otogenic cerebrospinal fluid (CSF) rhinorrhea with an intact tympanic membrane is a very rare symptom.
MethodsThe review of recent literature and case report of the 60-year old patient – a trumpeter presented with nontraumatic otogenic CSF rhinorrhea, intact tympanic membrane on microotoscopy, and besides colorless fluid in right nasal cavity, normal finding on nasal endoscopy examination.
ResultsCSF rhinorrhea was caused by CC in the petrous bone apex. Early diagnosis was facilitated by computed tomography scanning. Complete cholesteatoma removal was accomplished using a middle fossa craniotomy and an open non-radical antromastoidectomy.
ConclusionThe diagnosis of otogenic cerebrospinal fluid (CSF) rhinorrhea is challenging and it can easily be misdiagnosed. Congenital cholesteatoma is a rare entity. We present a non-classical presentation of CC in an adult male, with a previously unreported symptom of CSF rhinorrhea. Symptomatic improvement occurred after surgical treatment of the disease.
Keywords
Otogenic rhinorrhea, Cerebrospinal fluid leak, Otorhinorrhea, Congenital cholesteatoma
About this articleTitle
Non-classical presentation of congenital cholesteatoma as cerebrospinal fluid rhinorrhea – Case report and systematic review of the literature
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
183-188
Page views
319
Article views/downloads
449
DOI
10.1016/j.pjnns.2015.04.004
Bibliographic record
Neurol Neurochir Pol 2015;49(3):183-188.
Keywords
Otogenic rhinorrhea
Cerebrospinal fluid leak
Otorhinorrhea
Congenital cholesteatoma
Authors
Karolina Dzaman
Malgorzata Tomaszewska
Antoni Krzeski
Mariola Zagor
