{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:59:35Z","timestamp":1784185175134,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:00:00Z","timestamp":1600819200000},"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":[[2021,6]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Patients with spontaneous cerebrospinal fluid leaks (sCSF\u2010L) 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\u2010L patients also have calvarial thinning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective Cohort Study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of ASB sCSF\u2010L patients compared to nonobese (body mass index [BMI]\u2009&lt;\u200930\u2009kg\/m<jats:sup>2<\/jats:sup>) and obese (BMI\u2009\u2265\u200930) control groups. Twenty\u2010one patients in the ASB sCSF\u2010L group and 25 patients in each control group were included. Calvarium and extracranial zygoma thicknesses were measured bilaterally with blinded, standardized, volumetric analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>ASB sCSF\u2010L patients had a mean (SD) age of 50.43 (10.19) years, an average (SD) BMI of 38.81 (8.92) kg\/m<jats:sup>2<\/jats:sup>, and most were female (85.71%). The calvarium in patients with ASB sCSF\u2010L was significantly thinner than the nonobese (2.55\u2009mm [0.77] vs. 2.97 [0.67] mm; <jats:italic>P<\/jats:italic>\u00a0=\u2009.006; 95% confidence intervals [CI], 0.12\u20130.30; Cohen <jats:italic>d<\/jats:italic>, 0.58) and obese control groups (2.55 [0.77] vs. 2.92 [0.76] mm; <jats:italic>P<\/jats:italic>\u00a0=\u2009.02; 95% CI, 0.05\u20130.34; Cohen <jats:italic>d<\/jats:italic>, 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, <jats:italic>P<\/jats:italic>\u00a0=\u2009.9). The extracranial zygoma was not significantly different among the groups (analysis of variance, <jats:italic>P<\/jats:italic>\u00a0=\u2009.33).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ASB sCSF\u2010L patients have isolated calvarial thinning that is independent of obesity. Like lateral skull base sCSF\u2010L patients, these data suggest that the additional obesity\u2010associated intracranial process contributes to skull thinning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:1271\u20131276, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29130","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T14:04:52Z","timestamp":1600869892000},"page":"1271-1276","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Calvarium Thinning in Patients with Spontaneous Cerebrospinal Fluid Leaks of the Anterior Skull Base"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8107-9520","authenticated-orcid":false,"given":"Dhruv","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Indiana University  Indianapolis Indiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brady J.","family":"Tucker","sequence":"additional","affiliation":[{"name":"School of Medicine, Indiana University  Indianapolis Indiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Millay","sequence":"additional","affiliation":[{"name":"School of Medicine, Indiana University  Indianapolis Indiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kolin E.","family":"Rubel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Indiana University  Indianapolis Indiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0410-3010","authenticated-orcid":false,"given":"Mohamad","family":"Saltagi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Indiana University  Indianapolis Indiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5749-6383","authenticated-orcid":false,"given":"Rick F.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Indiana University  Indianapolis Indiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa A.","family":"Illing","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Indiana University  Indianapolis Indiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan Y.","family":"Ting","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Indiana University  Indianapolis Indiana 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