Cerebrospinal fluid rhinorrhea caused by a congenital defect of stapes mimicking otorrhea radionuclide cisternographic findings

A 13-year-old boy with congenital hearing loss of the left ear presented with watery rhinorrhea. He had two episodes of bacterial meningitis. The results of computed tomographic (CT) cisternography were unremarkable. Radionuclide cisternography using Tc-99m DTPA depicted abnormal radioactivity in the region of the left ear, suggesting cerebrospinal fluid (CSF) otorrhea, but there was no scintigraphic evidence of CSF rhinorrhea. At surgery, a common cavity anomaly of the left inner ear with CSF leakage into the middle ear through the perilymph fistula was found. This was repaired successfully with bone wax. The patient is doing well without rhinorrhea, but the hearing loss of the affected ear is permanent.