Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2025
Association of Obesity with Safety and Efficacy of Middle Cranial Fossa Repair of Spontaneous Cerebrospinal Fluid Leaks.
СтатьяНазвание и аннотация: Перевод в очереди
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Elms Hunter L, Totten Douglas J, Schneider William R, Yates Charles W, Cumpston Evan C, Nelson Rick F
Аннотация
OBJECTIVE: Determine if class 3, morbid obesity (body mass index, BMI >40 kg/m 2 ) patients have increased risk of complications following middle cranial fossa (MCF) repairs of spontaneous cerebrospinal fluid leaks (sCSF-Ls).
STUDY DESIGN: Retrospective cohort.
SETTING: Tertiary academic.
PATIENTS: Adults (>18 yrs old) with temporal bone CSF leak.
INTERVENTIONS: Middle fossa craniotomy CSF leak repair.
MAIN OUTCOME MEASURES: Comparison of perioperative complications according to American Surgical Association severity (grades 1-5) and rates of ipsilateral persistent leak within 90 days of initial surgery across obesity classes.
RESULTS: A total of 124 patients (64.5% female) with a mean (SD) age of 57 (11.3) years (range, 28-81) underwent MCF repairs of 142 spontaneous temporal bone leaks. Of these, 49.2% were right sided, 36.3% were left sided, and 14.5% were bilateral. The mean (SD) BMI was 38.1 (11.9) kg/m 2 [range, 23.6-85.4 kg/m 2 ], and the distribution of BMI categories was as follows: normal (2.4%), overweight (11.3%), class 1 obese (22.5%), class 2 obese (21.8%), class 3 obese (41.9%). Successful initial surgical repair was 97.2%, the mean length of stay was 2.4 (1.2) days, and 93.0% of patients experienced no complications. There was no difference in complication rates or severity scores, length of stay, or rates of persistent CSF leak across BMI categories.
CONCLUSIONS: Of sCSF-L patients, 41.9% have class 3 obesity, and MCF repair can be performed in this population at experienced centers with high success rates and few complications.
STUDY DESIGN: Retrospective cohort.
SETTING: Tertiary academic.
PATIENTS: Adults (>18 yrs old) with temporal bone CSF leak.
INTERVENTIONS: Middle fossa craniotomy CSF leak repair.
MAIN OUTCOME MEASURES: Comparison of perioperative complications according to American Surgical Association severity (grades 1-5) and rates of ipsilateral persistent leak within 90 days of initial surgery across obesity classes.
RESULTS: A total of 124 patients (64.5% female) with a mean (SD) age of 57 (11.3) years (range, 28-81) underwent MCF repairs of 142 spontaneous temporal bone leaks. Of these, 49.2% were right sided, 36.3% were left sided, and 14.5% were bilateral. The mean (SD) BMI was 38.1 (11.9) kg/m 2 [range, 23.6-85.4 kg/m 2 ], and the distribution of BMI categories was as follows: normal (2.4%), overweight (11.3%), class 1 obese (22.5%), class 2 obese (21.8%), class 3 obese (41.9%). Successful initial surgical repair was 97.2%, the mean length of stay was 2.4 (1.2) days, and 93.0% of patients experienced no complications. There was no difference in complication rates or severity scores, length of stay, or rates of persistent CSF leak across BMI categories.
CONCLUSIONS: Of sCSF-L patients, 41.9% have class 3 obesity, and MCF repair can be performed in this population at experienced centers with high success rates and few complications.