The Association Between Obesity and Spontaneous Temporal Bone CSF Leak Outcomes: A Systematic Review and Meta‐Analysis

Objective We undertook a systematic review of the literature with meta‐analysis to identify the role of obesity (BMI ≥30) in the patient characteristics presenting with spontaneous cerebrospinal fluid (sCSF) leaks of the lateral skull base and the outcomes of their repair. Data Sources A Systematic...

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Bibliographic Details
Published in:The Laryngoscope 2024-05, Vol.134 (5), p.2012-2018
Main Authors: Spinos, Dimitrios, Geropoulos, Georgios, Vavoulis, Georgios, Georgountzos, Georgios, Papageorgakopoulou, Manthia, Karela, Nina Rafailia, Varoutis, Panagiotis, Evangelou, Kyriacos, Cho, Wai Sum
Format: Article
Language:English
Subjects:
cerebrospinal fluid leak
Cerebrospinal Fluid Leak - etiology
Cerebrospinal Fluid Leak - surgery
CSF leak
Encephalocele - complications
Encephalocele - surgery
Female
Humans
lateral skull base
Male
Middle Aged
Obesity
Obesity - complications
Retrospective Studies
review
Skull Base - surgery
spontaneous
Systematic review
Temporal Bone - surgery
Treatment Outcome
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Summary:Objective We undertook a systematic review of the literature with meta‐analysis to identify the role of obesity (BMI ≥30) in the patient characteristics presenting with spontaneous cerebrospinal fluid (sCSF) leaks of the lateral skull base and the outcomes of their repair. Data Sources A Systematic Review of English Articles using MEDLINE, EMBASE, and Cochrane Library. Review Methods The research algorithm included the following keywords: “spontaneous CSF leak,” “lateral skull base,” “temporal bone,” “meningocele,” “encephalocele,” and “otorrhea.” We also manually searched the references of included studies, to identify possible studies missed during our literature search. Results More than two‐thirds of the patients were female (69.2%) and often were obese (mean BMI 36.5 kg/m2) with a mean age of 57. Most common presenting symptoms were otorrhea and hearing loss. Most authors did not report a routine use of a post‐operative lumbar drain. Most patients had a single skull base defect and encephaloceles prolapsing through, across obese and non‐obese groups. Median length of stay in hospital was 3.2 days, and the majority of patients did not have any recurrence during their follow‐up (89.6%), which was not affected by obesity. Conclusion Obesity does not affect length of hospital stay or recurrence rate following surgical repair of lateral skull base sCSF leaks. Surgical repair is a safe and viable approach in the management of obese patients with sCSF leaks in the temporal bone. Level of Evidence NA Laryngoscope, 134:2012–2018, 2024 This is a systematic review and meta‐analysis on the impact of increased body mass index (BMI) in the presentation and outcomes of spontaneous cerebrospinal fluid (sCSF) leaks of the lateral skull base. Reviewing the current literature, there is no evidence of adverse outcomes of surgical repair on patients with high BMI, nor do they have more extensive disease on their initial presentation. There is not enough evidence supporting the routine use of lumbar drains in either group of patients.
ISSN:0023-852X
1531-4995
1531-4995
DOI:10.1002/lary.31349