Calvarium Thinning in Patients with Spontaneous Cerebrospinal Fluid Leak

Nelson, Rick F.; Hansen, Kameron R.; Gantz, Bruce J.; Hansen, Marlan R.

doi:10.1097/mao.0000000000000552

Cited by 58 publications

(110 citation statements)

References 13 publications

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“…This is not surprising, because both superior canal dehiscence and spontaneous CSF fistula are characterized by a thin tegmen . Nelson et al demonstrated patients with spontaneous CSF fistula have thinner temporal bone squamosa than a control group of patients who underwent cochlear implantation . Whyte et al showed a similar relationship of a thin tegmen in patients with superior canal dehiscence .…”

Section: Discussionmentioning

confidence: 98%

Surgical management of spontaneous cerebrospinal fistulas and encephaloceles of the temporal bone

2018

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Section: Discussionmentioning

confidence: 98%

Surgical management of spontaneous cerebrospinal fistulas and encephaloceles of the temporal bone

2018

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“…This process may be expedited, or possibly congenital, in patients with low and/or thin skull bases (especially superior canal dehiscence syndrome [SCDS] patients) . Although a rapidly expanding body of literature has been devoted to this phenomenon over the past 2 decades, objective links between ICP, LPOP, and skull base thickness are currently lacking …”

Section: Specific Roles For the Otolaryngologistmentioning

confidence: 99%

Idiopathic intracranial hypertension: Contemporary review and implications for the otolaryngologist

et al. 2017

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Objectives: 1) Review controversies pertaining to the pathophysiology, diagnosis, and treatment of idiopathic intracranial hypertension. 2) Discuss the evolving role of otolaryngologists in managing this disease and related disorders.Data Sources: Primary literature review, Centers for Disease Control and Prevention website, International Classification of Headache Disorders, Second Edition.Methods: A comprehensive review of the primary literature was performed from 1990 to 2016 utilizing keywords idiopathic intracranial hypertension, pseudotumor cerebri, benign intracranial hypertension, spontaneous cerebrospinal fluid leak, and encephalocele. Articles were included at the discretion of the authors based on novel and/or historical contributions to the literature.Results: The incidence of idiopathic intracranial hypertension is increasing along with the obesity epidemic. Undiagnosed patients may present to otolaryngologists with pulsatile tinnitus, dizziness, sleep apnea, and spontaneous cerebrospinal fluid leaks. Although diagnosis is predicated upon imaging findings and lumbar puncture, radiographic signs including empty sella, optic nerve dilation, and globe flattening may suggest the diagnosis. The most effective intervention is weight loss combined with acetazolamide. Surgery is reserved for severe or refractory symptoms and can be highly morbid. Otolaryngologists are increasingly responsible for managing a number of secondary disorders including cerebrospinal fluid rhinorrhea and otorrhea. Failure to manage intracranial hypertension may lead to adverse surgical outcomes.Conclusions: The knowledge base for idiopathic intracranial hypertension has greatly expanded over the past 25 years. This disease is associated with a number of conditions directly relevant to otolaryngologists. A keen understanding of this disorder and its management may optimize outcomes in a growing number of patients.

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“…Many of the reports did not correlate the severity of OSA with polysomnography, nor was it offered to patients with OSA symptoms (snoring, excessive daytime sleepiness, and fatigue). [6][7][8]11 The lack of formal polysomnograms in all patients with spontaneous CSF leaks may have underestimated the incidence of OSA.…”

Section: Discussionmentioning

confidence: 97%

“…There was no difference in the skull thickness of patients with a spontaneous CSF leak and OSA compared with those with a spontaneous CSF leak without OSA. Fleischman et al 11 Nelson et al 8 Three published studies were included in the analysis: LeVay and Kveton, 6 Nelson et al, 8 and Fleischman et al 11 OR indicates odds ratio of bias; SE, standard error …”

Section: Summary Of Literature Search and Meta-analysismentioning

confidence: 99%

Association Between Obstructive Sleep Apnea and Spontaneous Cerebrospinal Fluid Leaks

Bakhsheshian

Hwang

Friedman

2015

JAMA Otolaryngol Head Neck Surg

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Calvarium Thinning in Patients with Spontaneous Cerebrospinal Fluid Leak

Abstract: Patients with spontaneous CSF leak are more likely to be obese, have the diagnosis of OSA, and show thinning of their entire calvarium that is independent of BMI. These data suggest an additional obesity-associated intracranial process contributes to skull thinning.

Cited by 58 publications

References 13 publications

Surgical management of spontaneous cerebrospinal fistulas and encephaloceles of the temporal bone

Surgical management of spontaneous cerebrospinal fistulas and encephaloceles of the temporal bone

Idiopathic intracranial hypertension: Contemporary review and implications for the otolaryngologist

Association Between Obstructive Sleep Apnea and Spontaneous Cerebrospinal Fluid Leaks

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