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The effect of prior radiation on the success of ventral skull base reconstruction: A systematic review and meta‐analysis
Author(s) -
Yong Michael,
Wu Yu Qi,
Su Shirley,
Hanna Ehab,
Prisman Eitan,
Thamboo Andrew,
Walgama Evan
Publication year - 2021
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26709
Subject(s) - skull , medicine , leak , meta analysis , cerebrospinal fluid leak , surgery , cerebrospinal fluid , incidence (geometry) , odds ratio , physics , optics , environmental engineering , engineering
The incidence of cerebrospinal fluid leak after ventral skull base reconstruction is a primary outcome of interest to skull base surgeons. Exposure to pre‐operative radiation may put patients at an increased risk of skull base reconstructive failure. A systematic search identified studies which included patients receiving ventral skull base reconstruction in the setting of pre‐operative radiation. A meta‐analysis using a random effects model was conducted to estimate an odds ratio of cerebrospinal fluid (CSF) leak in patients exposed to pre‐operative radiation. A meta‐analysis of 13 studies demonstrated that the odds ratio of CSF leak was 1.73 (95% CI 0.98–3.05). The majority of studies (77%) used vascularized tissue grafts for reconstruction. We identified an increased incidence of CSF leak among patients undergoing ventral skull base reconstruction after prior radiation therapy, although not of statistical significance. Skull base surgeons should exercise caution when planning reconstruction in this population.