Faculty Collaboration Database

Association of Obesity with Safety and Efficacy of Middle Cranial Fossa Repair of Spontaneous Cerebrospinal Fluid Leaks. Otol Neurotol 2026 Jan 01;47(1):201-206

Date

09/03/2025

Pubmed ID

40900431

DOI

10.1097/MAO.0000000000004621

Scopus ID

2-s2.0-105015386069 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

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.

Author List

Elms HL, Totten DJ, Schneider WR, Yates CW, Cumpston EC, Nelson RF

Author

Hunter L. Elms BS, MD Assistant Professor in the Otolaryngology and Communication Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Body Mass Index
Cerebrospinal Fluid Leak
Cranial Fossa, Middle
Craniotomy
Female
Humans
Male
Middle Aged
Obesity
Obesity, Morbid
Postoperative Complications
Retrospective Studies
Treatment Outcome