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Ear, Nose, and Throat Disorders

CSF leak?

05/02/2006

Question:

Hello, I`m a 38 year old male, and wondering if I might have a CSF leak. The area inside my left ear has been giving me problems over the past year, and the symptoms are getting worse. I often have a feeling of discomfort inside my ear (almost like the feeling of water up ones nose, only inside the ear). The left side of my neck is sore from what feels like fluid draining. I also can feel drainage in the back of my throat (with the "salty" taste as I`ve heard CSF described), and think I can also feel it in my lungs. I`ve had hearing loss and tinitus in my right ear along with occasional dizzy spells, and after exploratory surgery last month by my ENT, was diagnosed with otosclerosis in that ear. After explaining the additional symptoms of my left ear, he said he couldn`t detect any fluid, and said that my left ear symptoms could be from otosclerosis as well, giving me the "sensation" of fluid. I completely disagree, as I am certain that I have fluid draining inside my left ear, whether he could see it or not. Should I make an appointment to be tested for possible CSF leakage? Would it also be a good idea to get a chest x-ray? I did have an MRI done on my head region before my exploratory surgery, which didn`t determine anything. I should also mention that I`ve had additional symptoms that may or may not be related to this. I`ve had "tingling" sensations in my chest/shoulder/neck area, as well as an extremely hot/dry face, in constant need of lotion, which never used to be the case. I haven`t ever had a problem with headaches however, which seems to be a common symptom associated with CSF leakage. Thanks!

Answer:

Your symptoms are quite far afield from the usual presentation and manifestation for a CSF leak. That said, perhaps an evaluation from a Neurotologist would be beneficial.

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Response by:

Myles L Pensak, MD Myles L Pensak, MD
H. B. Broidy Professor and Chair of Otolaryngology
College of Medicine
University of Cincinnati