{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:45:26Z","timestamp":1788281126073,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T00:00:00Z","timestamp":1565568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spontaneous skull base defects can result in life\u2010threatening intracranial complications (ICCs), including meningitis and pneumocephalus. Endoscopic skull base reconstruction (ESBR) has traditionally been the treatment of choice, but its impact upon ICCs is not known. In this study, we aimed to describe the incidence rate of preoperative ICCs in patients with spontaneous skull base defects, risk factors associated with ICC development, and the impact of surgical repair on the incidence rate of ICCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was performed of all spontaneous skull base defects undergoing ESBR from 2005 to 2019 at 2 academic tertiary care medical centers. The incidence rate of ICCs and the demographics information and risk factors were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 222 spontaneous skull base defects, preoperative ICCs occurred in 46 subjects (20.7%) with an incidence rate of 22.7 per 100 person\u2010years. Factors significantly associated with preoperative ICCs included symptom duration, reduced body mass index (BMI), resolved cerebrospinal fluid rhinorrhea, and location in the frontal or lateral sphenoid sinuses. Endoscopic repair was successful in 97.2% of subjects and the postoperative ICC incidence rate was significantly reduced at 0.8 per 100 person\u2010years (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Spontaneous skull base defects pose significant risk for life\u2010threatening ICCs. Our findings reveal significantly elevated odds of ICC development associated with resolved CSF rhinorrhea, lower BMI, longer duration of symptoms, and defect location. Endoscopic repair is highly successful with low morbidity and significantly reduces the incidence rate of intracranial complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.22399","type":"journal-article","created":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T11:08:13Z","timestamp":1565608093000},"page":"1089-1096","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Endoscopic repair of spontaneous skull base defects decreases the incidence rate of intracranial complications"],"prefix":"10.1002","volume":"9","author":[{"given":"Jordan J.","family":"Allensworth","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2012Head &amp; Neck Surgery Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1296-2648","authenticated-orcid":false,"given":"Nicholas R.","family":"Rowan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2012Head &amp; Neck Surgery The Johns Hopkins University School of Medicine  Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina A.","family":"Storck","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2012Head &amp; Neck Surgery Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradford A.","family":"Woodworth","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2012Head &amp; Neck Surgery University of Alabama at Birmingham School of Medicine  Birmingham AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney J.","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2012Head &amp; Neck Surgery Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940711601206"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2008.22.3223"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2011.06.018"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e328011bc76"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812451090"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/194589240301700205"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21891"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2014.28.4002"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816630738"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2016.30.4319"},{"issue":"826","key":"e_1_2_6_12_1","article-title":"Endoscopic closure of CSF rhinorrhea: 193 cases over 21 years","volume":"140","author":"Banks CA","year":"2009","journal-title":"Otolaryngol Head Neck Surg"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200206000-00008"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/194589240301700403"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2003.12.018"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940611500703"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26581"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814551122"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24160"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21188"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.11-8220"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2006.12.040"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00298-7"},{"key":"e_1_2_6_24_1","unstructured":"World Health Organization.Global database on body mass index.2006.http:\/\/apps.who.int\/bmi\/index.jsp. Accessed April 19 2019."},{"issue":"288","key":"e_1_2_6_25_1","first-page":"1","article-title":"Prevalence of obesity among adults and youth: United States, 2015\u20102016","author":"Hales CM","year":"2017","journal-title":"NCHS Data Brief"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000535"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a55f17"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2010.03.003"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2014.07.018"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1325636"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200402000-00015"},{"key":"e_1_2_6_32_1","first-page":"277","article-title":"Closure of cerebrospinal fluid leaks prevents ascending bacterial meningitis","volume":"43","author":"Bernal\u2010Sprekelsen M","year":"2005","journal-title":"Rhinology"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26612"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22245"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13699"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.02.010"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2013.27.3986"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2015.10.025"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26982"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22327"}],"container-title":["International Forum of Allergy &amp; Rhinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Falr.22399","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.22399","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/alr.22399","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.22399","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T17:00:11Z","timestamp":1694192411000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/alr.22399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,12]]},"references-count":39,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1002\/alr.22399"],"URL":"https:\/\/doi.org\/10.1002\/alr.22399","archive":["Portico"],"relation":{},"ISSN":["2042-6976","2042-6984"],"issn-type":[{"value":"2042-6976","type":"print"},{"value":"2042-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,12]]},"assertion":[{"value":"2019-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}