The spontaneous discharge of cerebrospinal fluid from the nose was first positively established as a pathologic possibility by St. Clair Thomson1 in 1899. Since the publication of his monograph, reports of a considerable number of cases have appeared in the literature, although it is still regarded as an exceedingly infrequent condition.It has long been known that cerebrospinal fluid may escape from the ear after fractures of the base of the skull or following operations during which the inner ear or subdural space has been opened, but the literature dealing with spontaneous cerebrospinal otorrhea is apparently meager.Canfield,2 in 1913, reported a case of escape of cerebrospinal fluid and pus from the ear with no history of trauma, but the condition was preceded by pain in the ear for six weeks and impaired health for six months. The report of the autopsy was as follows:A plastic basal meningitis. The apex of the right temporal bone was occupied by a very large pneumatic cell containing cerebrospinal fluid and pus. The perforation through the wall of this cell had permitted the entrance of infection to the subdural space and the escape of cerebrospinal fluid externally into the pneumatic structure of the temporal bone, thence to the middle ear and external canal. Canfield in the same paper reported certain findings during an operation on the labyrinth which are of interest in connection with the case that I am presenting. Following is a quotation from his observations:The cerebellum was uncovered and an attempt made to open the labyrinth from behind. On account of the escape of cerebrospinal fluid from a small circular opening in the dura, which was probably a large perilymphatic duct opening atypically into the subdural space, this stage of the operation was not permitted.Although the hole in the dura was obliterated by a suture, the postoperative flow of cerebrospinal fluid was profuse and persistent until a
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.