Intrathecal fluorescein to localize cerebrospinal fluid leakage in bilateral mondini dysplasia

Recurrent meningitis caused by bilateral Mondini dysplasia presents a difficult diagnostic and therapeutic dilemma. A high-resolution computed tomographic scan with intrathecal contrast provided a false-positive identification for the side of cerebrospinal fluid leak in this patient. We report the intraoperative use of intrathecal fluorescein with mastoid tap to identify the side of cerebrospinal fluid leak in a 16-month-old boy with bilateral Mondini malformations. Both ears had been obliterated for recurrent cerebrospinal fluid leaks, while meningitis occurred after unilateral cochlear implantation.