{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:13:40Z","timestamp":1784693620749,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,8,8]],"date-time":"2015-08-08T00:00:00Z","timestamp":1438992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>The goals of this study are to: 1) investigate the urgency for repair of middle cranial fossa spontaneous cerebrospinal fluid (CSF) leaks in adults, and 2) review the literature and treatment recommendations for adult spontaneous CSF otorrhea.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>1) All patients who were referred to a tertiary center with spontaneous CSF otorrhea, exposed middle cranial fossa dura, or encephalocele from 2004 to 2015; and 2) landmark references on spontaneous CSF leaks<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>Electronic medical records of patients with a documented spontaneous CSF leak, exposed dura, or encephalocele were reviewed. Subjects were excluded if they had a congenital, traumatic, or iatrogenic CSF leak. Main outcome measure was duration of CSF leak and development of meningitis after clinical presentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two patients (27 ears) who were at risk for meningitis from spontaneous CSF otorrhea, encephalocele, or a dural breach with or without mastoiditis were evaluated. Duration of CSF leaks in patients who refused repair or who continued to have CSF leak after repair or prior to successful repair ranged from 4 months to 11 years. Duration of encephaloceles and dural exposure in an uninfected mastoid ranged from 24 months to 6 years. Only one patient presented with meningitis. None of these 22 patients developed meningitis during the time periods they were under our care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Should patients with CSF otorrhea, exposed dura, or encephalocele refuse operation, it may be reasonable to follow them with close observation and education about warning signs for meningitis. <jats:italic>Laryngoscope<\/jats:italic>, 126:464\u2013468, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25461","type":"journal-article","created":{"date-parts":[[2015,8,8]],"date-time":"2015-08-08T13:29:07Z","timestamp":1439040547000},"page":"464-468","source":"Crossref","is-referenced-by-count":34,"title":["Spontaneous middle cranial fossa cerebrospinal fluid otorrhea in adults"],"prefix":"10.1002","volume":"126","author":[{"given":"Neela","family":"Rao","sequence":"first","affiliation":[{"name":"University of Illinois at Chicago Chicago Illinois U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Redleaf","sequence":"additional","affiliation":[{"name":"Department of Otology\/Neurotology Illinois Hospitals and Health Sciences System Chicago Illinois U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,8,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200301000-00010"},{"key":"e_1_2_6_3_1","first-page":"770","article-title":"Adult spontaneous cerebrospinal fluid otorrhea: diagnosis and management","volume":"20","author":"Gacek RR","year":"1999","journal-title":"Am J Otol"},{"key":"e_1_2_6_4_1","first-page":"653","article-title":"Wilkin Ecoulement spontan\u00e9 de liquide c\u00e9phalorachidien par le conduit auditif externe; fistule cong\u00e9nitale probable. [French]","volume":"10","author":"Eschat E","year":"1897","journal-title":"Arch Internat de Laryng"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198606000-00009"},{"key":"e_1_2_6_6_1","first-page":"221","article-title":"Some conditions associated with the loss of cerebrospinal fluid","volume":"19","author":"Canfield RB","year":"1913","journal-title":"The Annual Meeting of the American Laryngological, Rhinological, and Otological Society"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1931.04230020125008"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1933.03580060040003"},{"key":"e_1_2_6_9_1","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1288\/00005537-193408000-00007","article-title":"Cerebrospinal otorrhea. Report of two cases (Review of Literature)","volume":"44","author":"Ersner","year":"1934","journal-title":"Laryngoscope"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1932.03570030907007"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1944.01230020080001"},{"key":"e_1_2_6_12_1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/BF01743711","article-title":"Bongartz EB, Nau H\u2010E, Liesegang J. The cerebrospinal fluid fistula. Rhinorrhoea, otorrhoea and orbitorrhoea","volume":"4","year":"1981","journal-title":"Neurosurg Rev"},{"key":"e_1_2_6_13_1","first-page":"553","article-title":"Recurrent meningitis due to a congenital fistula through the stapes footplate","volume":"120","author":"Schultz P","year":"1970","journal-title":"Am J Dis Child"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348947908800311"},{"key":"e_1_2_6_15_1","first-page":"67","article-title":"Congenital labyrinthotympanic fistula\u2010a recently recognized entity in children","volume":"10","author":"Guindi GM","year":"1981","journal-title":"J Otolaryngol"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459988509300511"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.25461","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.25461","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T06:46:05Z","timestamp":1695710765000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.25461"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8,8]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1002\/lary.25461"],"URL":"https:\/\/doi.org\/10.1002\/lary.25461","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,8]]}}}