{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:37:24Z","timestamp":1785497844496,"version":"3.56.0"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,12,13]],"date-time":"2013-12-13T00:00:00Z","timestamp":1386892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Spontaneous occurrence of otogenic cerebrospinal fluid (CSF) effusion is now far more prevalent than causes related to infections, prior surgeries, or trauma\u2014trends that may be increasing because of higher rates of obesity and improved diagnostic awareness. In our patient cohort with spontaneous CSF effusion, we report its association with obesity and audiological findings before and after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In our 45 patients (46 ears) with CSF effusion (with or without lateral skull base meningoencephaloceles), we report clinical data, imaging studies, audiogram results, operative techniques, and recurrence rates. Causes included 33 spontaneous, 10 due to chronic otitis media, one iatrogenic, and one traumatic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Body mass index (BMI) averaged 35 overall (37 for spontaneous type and 32 for nonspontaneous type). Surgical repair of skull base defect was performed using three middle fossa approaches, 24 combined transmastoid\/middle fossa, and 19 transmastoid alone. Overall recurrence of CSF leaks was 6.5%. Thirty patients had audiograms available. Sensorineural hearing loss occurred in 10% of patients. Air\u2010bone gap improved by\u2009\u2265\u200915 dB in 20% of patients and worsened by\u2009\u2265\u200915 dB in 6.7% of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with spontaneous CSF effusion had a BMI higher than in the nonspontaneous group, but the difference was not statistically significant. However, the dramatic trend toward spontaneous CSF effusion heightens the need for clinician's acumen for diagnosis, particularly in overweight\/obese patients. Our audiological outcomes confirm the efficacy of surgical approaches in correcting conductive hearing loss and preserving bone conduction, although hearing loss is a risk during surgical repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 124:1204\u20131208, 2014<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24484","type":"journal-article","created":{"date-parts":[[2013,10,26]],"date-time":"2013-10-26T09:18:42Z","timestamp":1382779122000},"page":"1204-1208","source":"Crossref","is-referenced-by-count":48,"title":["Spontaneous Cerebrospinal fluid effusion of the temporal bone: Repair, audiological outcomes, and obesity"],"prefix":"10.1002","volume":"124","author":[{"given":"Hwa J.","family":"Son","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Cincinnati Ohio U.S.A"},{"name":"Mayfield Clinic Cincinnati Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Karkas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Cincinnati Ohio U.S.A"},{"name":"Mayfield Clinic Cincinnati Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Buchanan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Cincinnati Ohio U.S.A"},{"name":"Mayfield Clinic Cincinnati Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Giurintano","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Cincinnati Ohio U.S.A"},{"name":"Mayfield Clinic Cincinnati Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Theodosopoulos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Cincinnati College of Medicine Cincinnati Ohio U.S.A"},{"name":"Mayfield Clinic Cincinnati Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myles L.","family":"Pensak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Cincinnati Ohio U.S.A"},{"name":"Mayfield Clinic Cincinnati Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi N.","family":"Samy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Cincinnati Ohio U.S.A"},{"name":"Neurosensory Disorders Center at the U.C. 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