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HYRTL’S FISSURE

Hyrtl's fissure is a transient anatomical landmark in the developing fetal petrous temporal bone. It is a communication between the middle ear cavity and the meninges of the posterior fossa. Clinical Importance Spontaneous Cerebrospinal Fluid (CSF) Otorrhea: The persistence of Hyrtl's fissure into adulthood can lead to a rare condition called spontaneous CSF otorrhea. This occurs when CSF leaks from the meninges into the middle ear, causing symptoms like clear fluid drainage from the ear and hearing loss. Cochlear Implant Surgery: In some cases, a persistent Hyrtl's fissure may be a complication during cochlear implant surgery. The surgeon must be aware of this anatomical variation to avoid accidentally inserting the cochlear implant electrode into the fissure, which could lead to CSF leakage and complications. Key Points Hyrtl's fissure is a temporary structure during fetal development. Its persistence into adulthood is rare. It can be a cause of spontaneous CSF otorrhea. Surgeons performing cochlear implant surgery should be aware of this anatomical variation.