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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:963-966, April 2005
© 2005 American Society of Neuroradiology

Case Report
HEAD AND NECK

Hyrtl’s Fissure: A Case of Spontaneous Cerebrospinal Fluid Otorrhea

F. Jégoux^a, O. Malard^a, M. Gayet-Delacroix^b, P. Bordure^a, F. Legent^a and C. Beauvillain de Montreuil^a

^a Service d’ORL et chirurgie cervico-faciale, CHU Hotel-Dieu, Nantes, France
^b Service de Radiologie, CHU Hotel-Dieu, Nantes, France

Address correspondence to Dr. Franck Jégoux, Service d’ORL et chirurgie cervico-faciale, 44093 Nantes cedex 1, France

Summary: Spontaneous CSF otorrhea is a relatively rare entity. Adequate diagnosis and treatment are needed to avoid life-threatening complications such as meningitis. Because diagnosis is based on CT findings, identification of the different pathways of congenital fistulas requires detailed knowledge of embryology and anatomy. The facial canal, petromastoid canal, and tympanomeningeal (Hyrtl’s) fissure can be responsible for CSF fluid otorrhea in the absence of any abnormality of the adjacent membranous labyrinth. We report the first documented and imaging case of Hyrtl’s fissure and its treatment.

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