Spontaneous CSF otorrhoea - Presenting as conductive deafness.

Spontaneous CSF otorrhea specially in older age is a rare condition. Congenital inner ear malformation is one of the commonest causes in pediatric age group and either because of trauma or spontaneously it comes out into middle ear. In pediatric age group usual presentation is with history of meningitis while adult patients may present as watery discharge from nose or ear. This is a case, presented with conducted deafness with negative middle ear pressure. Grommet was put presuming secretory otitis media but B2-transferrin levels of the secretion confirmed it as a CSF otorrhea. He was operated with past aural transmasioid approach. The defect was sealed in layers. Patient is in regular follow up is asymptomatic and without any recurrence.