Cerebrospinal fluid otorrhea presenting in complicated chronic suppurative otitis media.

Since the introduction of antibiotics, the simultaneous occurrence of multiple intra- and extracranial complications in chronic suppurative otitis media (CSOM) has been uncommon. Such a combination is associated with high mortality and morbidity, especially in the pediatric age group. Cerebrospinal fluid (CSF) otorrhea presenting in CSOM is unusual and rare. To the best of our knowledge, only 19 cases of CSF otorrhea in complicated CSOM have been previously reported in the literature. Identifying the site of leak might require a high index of suspicion. Management of such a case could be challenging in terms of leak closure, disease clearance, and restoration of function. We report a new case of CSF leak in CSOM, and we describe our line of management. Even though CSOM is an uncommon indication for radical mastoidectomy today, such surgery might be necessary for these cases.