Predictors of failure of recurrent spontaneous CSF rhinorrhea repair: a prospective cohort study

Background To identify and predict risk factors associated with recurrent spontaneous cerebrospinal fluid (CSF) rhinorrhea, a cohort study included a total of 37 adult patients with spontaneous CSF rhinorrhea were analyzed. Results Over a 2-year period, 37 patients of spontaneous CSF leak with exclu...

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Published inThe Egyptian journal of otolaryngology Vol. 39; no. 1; pp. 133 - 7
Main Authors Maltan, Turkiya A., Salem, Eman H., Eldeeb, Ahmed Hemdan, Moneir, Waleed, Khafagy, Yasser W.
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2023
Springer
Springer Nature B.V
SpringerOpen
Subjects
Body mass index
Cohort analysis
COVID-19
CSF leak
Defects
Development and progression
Drug dosages
Endoscopic repair
Genetic disorders
Headaches
Hypertension
Magnetic resonance imaging
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Meningitis
Optic nerve
Original Article
Patients
Recurrent
Risk factors
Spontaneous
Surgery
CSF leak
Recurrent
Spontaneous
Endoscopic repair
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Summary:Background To identify and predict risk factors associated with recurrent spontaneous cerebrospinal fluid (CSF) rhinorrhea, a cohort study included a total of 37 adult patients with spontaneous CSF rhinorrhea were analyzed. Results Over a 2-year period, 37 patients of spontaneous CSF leak with exclusion of other etiologies (traumatic, congenital) were enrolled: primary (non-recurrent) ( n = 20) and secondary (recurrent) ( n = 17), where 83.8% were females with an average body mass index (BMI) of 36.4 kg/m 2 . Associated symptoms of high intracranial pressure (ICP) namely, blurred vision and unsteadiness ( P -value = 0.006 and 0.01, respectively), multiparity (92.3%), and failure to localize the defect (17.6%) contributed to patients having more recurrence. Although the cribriform plate was detected frequently ( n = 29.4%), they were associated with lower recurrence compared to lateral recess of sphenoid (66.6% vs 20%). Conclusion Direct endoscopic visualization and repair of skull base defects achieve a high success rate, but failure is still a possibility especially in spontaneous etiology of leaks. In a multiparous female, with high CSF pressure, lateral sphenoid recess, large size, or unidentified defect, the incidence of recurrence is much higher. Level of evidence 4
ISSN:2090-8539
1012-5574
2090-8539
DOI:10.1186/s43163-023-00484-2