Pediatric meningocele with cerebrospinal fluid drainage into the subcutaneous tissue of the external auditory canal.
Takaki Akita, Masaya Matsuda, Kentaro Ichijo et al.
✦ AI-curated · Sources linked
Case in brief
A 2-year-old girl presented with refractory otitis media, revealing ossicular demineralization and internal auditory canal expansion on CT. At 10 years, despite improved middle ear aeration, she had persistent symptoms. Exploratory tympanotomy revealed CSF leakage from the anterior epitympanum into the external auditory canal's subcutaneous tissue, causing canal swelling. Surgical repair successfully resolved the leakage, with postoperative imaging confirming meningoceles.
What made this case unusual
The case is notable for the CSF leakage bypassing the middle ear and tracking directly into the subcutaneous tissue of the external auditory canal, which is atypical for temporal bone meningoceles.
Diagnostic / clinical pearl
Clinicians should consider the possibility of CSF leakage into subcutaneous tissues in cases of refractory otitis media, especially when typical middle ear effusion is absent.
Why it matters
This case highlights the importance of recognizing atypical presentations of CSF leakage for accurate diagnosis and effective surgical intervention.