Spontaneous Leak of Cerebrospinal fluid (CSF) into the middle ear cavity can occur in adults without a history of temporal bone trauma or fracture, meningitis or any obvious cause, it may result from a number of congenital deformities of the ear. Mondini deformity an abnormal development of the cochlea is frequently associated with CSF leakage therefore clues may be lacking that would alert the otolaryngologist that fluid medial to an intact ear drum are fluid emanating from an ear drum perforation is likely to be CSF fluid. Here we are presenting a case of spontaneous CSF leaks in two sites and treated with surgical closure with cartilage graft.

Super Vasmol is one of the commonly used, cheap, freely available hair dye poisoning is emerging a major cause of suicidal poisoning in India, and the hair dyes mainly contain paraphenylene diamine (PPD) and resorcinol. Acute poisoning by PPD causes characteristic sever angio-neurotic oedema of upper air way associated with a swollen, dry, hard and protruding tongue, systemic intoxication results in multisystem involvement and can cause rhabdomyolysis, acute renal failure (ARF). There is no specific antidote for PPD and treatment mainly supportive, emergency tracheostomy will help the patient to relieve the airway obstruction and reduce mortality. We report a case of suicidal ingestion of hair dye that was presented with cervico-fascial oedema later developed rhabdomyolysis and acute renal failure managed with emergency tracheostomy, systemic management and dialysis.