{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:44:45Z","timestamp":1789548285897,"version":"build-2803163510"},"reference-count":18,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,4]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The aim in this paper was to determine risk factors for the development of a postoperative CSF leak after an endoscopic endonasal approach (EEA) for resection of skull base tumors.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A retrospective review of patients who underwent EEA for the resection of intradural pathology between January 1997 and June 2012 was performed. Basic demographic data were collected, along with patient body mass index (BMI), tumor pathology, reconstruction technique, lumbar drainage, and outcomes.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Of the 615 patients studied, 103 developed a postoperative CSF leak (16.7%). Sex and perioperative lumbar drainage did not affect CSF leakage rates. Posterior fossa tumors had the highest rate of CSF leakage (32.6%), followed by anterior skull base lesions (21.0%) and sellar\/suprasellar lesions (9.9%) (p < 0.0001). There was a higher leakage rate for overweight and obese patients (BMI > 25 kg\/m\n 2<\/jats:sup>\n ) than for those with a healthy-weight BMI (18.7% vs 11.5%; p = 0.04). Patients in whom a pedicled vascularized flap was used for reconstruction had a lower leakage rate than those in whom a free graft was used (13.5% vs 27.8%; p = 0.0015). In patients with a BMI > 25 kg\/m\n 2<\/jats:sup>\n , the use of a pedicled flap reduced the rate of CSF leakage from 29.5% to 15.0% (p = 0.001); in patients of normal weight, this reduction did not reach statistical significance (21.9% [pedicled flap] vs 9.2% [free graft]; p = 0.09).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n \n Preoperative BMI > 25 kg\/m\n 2<\/jats:sup>\n and tumor location in the posterior fossa were associated with higher rates of postoperative CSF leak. Use of a pedicled vascularized flap may be associated with reduced risk of a CSF leak, particularly in overweight patients.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.12.jns1694","type":"journal-article","created":{"date-parts":[[2017,6,9]],"date-time":"2017-06-09T09:58:42Z","timestamp":1497002322000},"page":"1066-1071","source":"Crossref","is-referenced-by-count":159,"title":["Risk factors associated with postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery"],"prefix":"10.3171","volume":"128","author":[{"given":"Shannon","family":"Fraser","sequence":"first","affiliation":[{"name":"Departments of Otolaryngology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Koutourousiou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Kubik","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C.","family":"Fernandez-Miranda","sequence":"additional","affiliation":[{"name":"Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl H.","family":"Snyderman","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology and"},{"name":"Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric W.","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurol Surg Rep","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1055\/s-0032-1331022","article-title":"The efficacy and safety of preoperative lumbar drain placement in anterior skull base surgery","volume":"74","author":"Ackerman PD","year":"2013","unstructured":"Ackerman PD, Spencer DA, Prabhu VC: The efficacy and safety of preoperative lumbar drain placement in anterior skull base surgery. 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