Geniculate ganglion pseudocyst: Cases Series and Review of Literature

Nontraumatic, non-iatrogenic cerebrospinal fluid (CSF) otorrhea is rare in the pediatric population. We present three cases of spontaneous cerebrospinal fluid otorrhea in children where geniculate ganglion pseudocysts were ultimately found to be the underlying etiology. In one case, the presenting symptom was gradual hearing loss and was treated nonsurgically. In the second case, the patient presented with a low-frequency hearing loss that progressed quickly to severe sensorineural hearing loss. In the third case, the patient presented with recurrent otorrhea after remote surgery and underwent a subtotal petrosectomy to repair the leak. In addition to reviewing these cases, their subtle radiologic findings, and their outcomes, we review literature on management of pediatric cysts and pseudocysts in the region of the fallopian canal. Pediatric patients with unexplained hearing loss/rhinorrhea or otorrhea recalcitrant to standard treatment should be evaluated for possible congenital inner ear malformations. Standard imaging and high clinical suspicion will guide the provider to the correct diagnosis. This review of the literature on geniculate ganglion pseudocyst can help aid in proper diagnosis and management.