A 44-year-old Chinese man with a history of nasopharyngeal carcinoma that was treated with radiotherapy presented with fluid in the middle ear. We performed a myringotomy and subsequently made a diagnosis of cerebrospinal fluid (CSF) leakage secondary to osteoradionecrosis of the temporal bone. To the best of our knowledge, this is only the second reported case of an otogenic CSF leak resulting from osteoradionecrosis of the temporal bone. This case highlights the controversial role of myringotomy in the management of CSF otorrhea.
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