Spontaneous CSF Otorrhea: Diagnosis and Management

PROGRAM DESCRIPTION: This series will focus on the diagnosis and management of spontaneous CSF (sCSF) leaks. Topics to be covered will include preoperative diagnostics to confirm diagnosis of sCSF leak, imaging methods to localize the CSF leak, surgical management of sSCF leaks and postoperative management of comorbid conditions that contribute to sCSF leaks such as sleep apnea and intracranial hypertension.

This series is significant because patient morbidity (including meningitis, neurologic compromise and potentially death) can result from unrecognized or insufficiently treated sCSF leaks. The rate of sCSF leaks has more than doubled in the past decade and is highly associated with obesity. Thus, sCSF leaks need to be recognized by all otolaryngologists so patient treatment is not delayed. Incorrect or delayed diagnosis of sCSF leaks leads to increased medical costs related to physician visits, costs and risks of non-effective medications, costs and risks of non-effective procedures (i.e. tympanomastoidectomy, CSF otorrhea occurring after placement of a tympanostomy tube in a patient with presumed serous otitis media).

The goal of this series is that all physicians will be able to recognize and diagnose sCSF leaks leading to expeditious treatment.

OUTCOME OBJECTIVE 1: Understand the preoperative diagnosis of sCSF leaks

OUTCOME OBJECTIVE 2: Recognize the contributing factors to the development of sCSF leaks and how to manage these conditions

OUTCOME OBJECTIVE 3: Know the current surgical treatment and outcomes for patients with sCSF leaks

BACKGROUND STATEMENT: Many general otolaryngologists still do not recognize and diagnose spontaneous CSF leaks, likely from lack of knowledge of who is at risk and diagnostic evaluations. The rate of sCSF leaks is increasing by 10% per year over the past 2 decades.

Comprehensive Otolaryngology Track Statement :