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Incidence of Postoperative CSF Leaks in Class III Obese Patients Undergoing Middle Cranial Fossa Approach for Spontaneous CSF Leak Repair.
Cutri, Raffaello M; Shibata, Seiji B; Zhang, Huan; Gantz, Bruce J; Hansen, Marlan R.
Afiliación
  • Cutri RM; Keck School of Medicine, University of Southern California. Los Angeles, California.
  • Shibata SB; Department of Otolaryngology, University of Southern California. Los Angeles, California.
  • Zhang H; Department of Otolaryngology, University of California Los Angeles. Los Angeles, California.
  • Gantz BJ; Department of Otolaryngology-Head & Neck Surgery University of Iowa Hospitals & Clinics. Iowa City, Iowa.
  • Hansen MR; Department of Otolaryngology-Head & Neck Surgery University of Iowa Hospitals & Clinics. Iowa City, Iowa.
Otol Neurotol ; 44(4): 382-387, 2023 04 01.
Article en En | MEDLINE | ID: mdl-36791337
OBJECTIVE: To determine the safety and effectiveness of the middle cranial fossa (MCF) approach for spontaneous cerebrospinal fluid leak (sCSF-L) repair in class III obese patients. To also assess the need for prophylactic lumbar drain (LD) placement in this patient population. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary Academic Center. PATIENTS: All patients older than 18 years undergoing sCSF-L repair with an MCF approach. INTERVENTION: An MCF craniotomy for sCSF-L repair. MAIN OUTCOME MEASURE: Rate of complications and postoperative leaks. RESULTS: There were no perioperative complications in 78.9% (56/71) of cases. The surgical complication rate was 12.5% (2/16), 10% (2/20), and 22.2% (6/27) in class I, class II, and class III obese patients. There was no statistically significant difference in complications among these three groups. The most common postoperative complication was a persistent CSF leak in the acute postoperative period with an overall rate of 9.9% (7/71) with six of the seven patients requiring postoperative LD placement. The percentage of postoperative CSF leaks in nonobese, class I, class II, and class III patients were 25% (2/8), 12.5% (2/16), 0% (0/20), and 11.1% (3/27), respectively. There was no statistically significant difference in the rate of postoperative CSF leaks among the four groups (chi-square, p = 0.48). In all cases, the acute postoperative CSF leaks resolved in the long term and did not require further surgical repair. CONCLUSIONS: We determine that MCF craniotomy repair for sCSF-Ls is safe in patients with class III obesity, and the incidence of postoperative CSF leaks did not vary among other obesity classes. We also find that prophylactic placement of LDs is not routinely needed in this population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fosa Craneal Media / Pérdida de Líquido Cefalorraquídeo Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Otol Neurotol Asunto de la revista: NEUROLOGIA / OTORRINOLARINGOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fosa Craneal Media / Pérdida de Líquido Cefalorraquídeo Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Otol Neurotol Asunto de la revista: NEUROLOGIA / OTORRINOLARINGOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos