{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:45:22Z","timestamp":1788281122527,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T00:00:00Z","timestamp":1574812800000},"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":["The Laryngoscope"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the prevalence and impact of obstructive sleep apnea (OSA) and obesity in lateral skull base cerebrospinal fluid leak repair (LSBR) of various etiologies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective case review at a tertiary skull base center was conducted of consecutive adults undergoing LSBR via transmastoid, middle cranial fossa, or combined approach between 2013\u20132018. The following data were collected: demographics, comorbidities, radiology and intraoperative findings, and surgical outcomes including complications and need for revision surgery or shunt placement. Patients with incomplete data or leaks following skull base surgery, trauma or chronic ear disease were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010four patients (67.4% female, mean age 53.5\u2009\u00b1\u200912.9\u2009years) underwent repair for<\/jats:p><jats:p>spontaneous (sCSFL, 44%) and other etiology (nsCSFL) leaks. nsCSFL served as a comparison<\/jats:p><jats:p>group consisting of leaks status\u2010post lateral skull base surgery, temporal bone fractures, and<\/jats:p><jats:p>chronic ear disease. Class III obesity (<jats:italic>P<\/jats:italic> =\u2009.02), OSA (<jats:italic>P<\/jats:italic> =\u2009.03), and imaging findings of empty sella (OR = 3.32, <jats:italic>P<\/jats:italic> =\u2009.02), and skull base thinning including contralateral tegmen thinning (31%, OR = 4.3, <jats:italic>P<\/jats:italic> =\u2009.02), arachnoid granulations (26%, OR = 4.35, <jats:italic>P<\/jats:italic> =\u2009.02), and superior canal dehiscence (15.8%, OR = 8.57, <jats:italic>P<\/jats:italic> =\u2009.04) were more common in sCSFL. Four patients (4.2%) required surgical revision for recurrence, and another four (4.2%) resolved with shunting. Evidence of elevated intracranial hypertension was present in nine patients with sCSF leaks and was predictive of need for revision or shunt procedures (<jats:italic>P<\/jats:italic> &lt;\u2009.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Obesity, OSA, and imaging consistent with elevated intracranial pressures were more common among patients with sCSFL. Elevated intracranial pressure predicted outcomes following multilayer repair of spontaneous CSF leaks<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 130:2234\u20132240, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28421","type":"journal-article","created":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T15:42:53Z","timestamp":1574869373000},"page":"2234-2240","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Impact of Obesity and Obstructive Sleep Apnea in Lateral Skull Base Cerebrospinal Fluid Leak Repair"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1561-4649","authenticated-orcid":false,"given":"Kristen L.","family":"Yancey","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Vanderbilt University  Nashville Tennessee 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