{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:23:17Z","timestamp":1784956997182,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,2,23]],"date-time":"2016-02-23T00:00:00Z","timestamp":1456185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>(1) Correlate skull base thickness with perioperative outcomes for spontaneous cerebrospinal fluid (CSF) otorrhea. (2) Augment perioperative counseling of patients with abnormally thin skull bases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary center. Patients with spontaneous CSF otorrhea have thin skull bases. This is associated with obesity and\/or idiopathic intracranial hypertension. The influence of skull base thinning on perioperative outcomes is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>A retrospective review was conducted from 2004 to 2014. Forty\u2010eight cases of spontaneous CSF otorrhea met the inclusion criteria of primary surgery by the senior authors: preoperative dedicated temporal bone computed tomography, absence of other leak etiologies, and follow\u2010up &gt;6\u00a0months. Patients were stratified into thin (&lt;0.9\u00a0mm) and thick (&gt;0.9\u00a0mm) groups based on computed tomography measures of their tegmen. Primary outcomes measures were as follows: postoperative meningitis, recurrent leak, second site leak (contralateral ear\/anterior fossa), and permanent shunt placement. Hearing outcomes were not assessed in this study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty and 15 patients composed the thin and thick groups, respectively. Both the incidence (<jats:italic>P<\/jats:italic> &lt;. 0001) and the rate (<jats:italic>P<\/jats:italic> =. 005) of adverse outcomes were significantly higher in the thin group. Only 2 patients in the thick group experienced an adverse outcome. Eleven patients underwent multiple procedures for spontaneous leaks. The recurrence rate was 14.5%. All but 1 recurrence occurred in the thin group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An abnormally thin tegmen was significantly associated with adverse perioperative outcomes in cases of spontaneous CSF otorrhea. A thick skull base and the presence of an encephalocele may be protective against recurrence. The effect of untreated intracranial hypertension on the results is unknown.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599816628528","type":"journal-article","created":{"date-parts":[[2016,2,23]],"date-time":"2016-02-23T22:43:55Z","timestamp":1456267435000},"page":"707-714","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Association between Lateral Skull Base Thickness and Surgical Outcomes in Spontaneous CSF Otorrhea"],"prefix":"10.1002","volume":"154","author":[{"given":"Shawn M.","family":"Stevens","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Cincinnati Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habib G.","family":"Rizk","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Medical University of South Carolina Charleston South Carolina 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