Hendriks T, et al. - Researchers conducted a retrospective cohort study of patients with biochemically confirmed spontaneous cerebrospinal fluid leaks of the temporal bone manifesting as middle ear fluid with no other obvious cause in order to report on their clinical profile, symptoms and examination findings. In addition, investigation was performed with respect to their management outcomes. They assessed a total of 90 adult patients with spontaneous cerebrospinal fluid otorrhoea. The commonest presenting symptom was unilateral hearing loss was (81%). In this study, one of the largest cohorts of spontaneous cerebrospinal fluid otorrhoea has been reported. Findings highlight the importance of having a high index of suspicion for this condition when encountering patients presenting with a unilateral middle ear effusion, especially in those who are overweight. Surgical intervention was identified to be linked with a risk of recurrence and further studies are required to ascertain the risk of intra-cranial infection in order to guide management.