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Calvarium Thinning in Patients with Spontaneous Cerebrospinal Fluid Leaks of the Anterior Skull Base
Author(s) -
Sharma Dhruv,
Tucker Brady J.,
Millay David S.,
Rubel Kolin E.,
Saltagi Mohamad,
Nelson Rick F.,
Illing Elisa A.,
Ting Jonathan Y.
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29130
Subject(s) - medicine , confidence interval , cerebrospinal fluid , skull , retrospective cohort study , body mass index , surgery , nuclear medicine
Objectives/Hypothesis Patients with spontaneous cerebrospinal fluid leaks (sCSF‐L) of the temporal bone have isolated calvarial and skull base thinning that is independent of obesity. This study determines if anterior skull base (ASB) sCSF‐L patients also have calvarial thinning. Study Design Retrospective Cohort Study. Methods This was a retrospective cohort study of ASB sCSF‐L patients compared to nonobese (body mass index [BMI] < 30 kg/m 2 ) and obese (BMI ≥ 30) control groups. Twenty‐one patients in the ASB sCSF‐L group and 25 patients in each control group were included. Calvarium and extracranial zygoma thicknesses were measured bilaterally with blinded, standardized, volumetric analysis. Results ASB sCSF‐L patients had a mean (SD) age of 50.43 (10.19) years, an average (SD) BMI of 38.81 (8.92) kg/m 2 , and most were female (85.71%). The calvarium in patients with ASB sCSF‐L was significantly thinner than the nonobese (2.55 mm [0.77] vs. 2.97 [0.67] mm; P = .006; 95% confidence intervals [CI], 0.12–0.30; Cohen d , 0.58) and obese control groups (2.55 [0.77] vs. 2.92 [0.76] mm; P = .02; 95% CI, 0.05–0.34; Cohen d , 0.66). The calvarium thickness of the nonobese patients was not significantly different from the obese patient controls (2.97 [0.67] vs. 2.92 [0.76] mm, P = .9). The extracranial zygoma was not significantly different among the groups (analysis of variance, P = .33). Conclusions ASB sCSF‐L patients have isolated calvarial thinning that is independent of obesity. Like lateral skull base sCSF‐L patients, these data suggest that the additional obesity‐associated intracranial process contributes to skull thinning. Level of Evidence 4 Laryngoscope , 131:1271–1276, 2021