Association Between Body Mass Index and Complications in Acoustic Neuroma Surgery

Abstract

Objectives Elevated body mass index (BMI) is a risk factor for surgical complications, but data in acoustic neuroma surgery are conflicting and limited to small single-institution studies. This work evaluates associations between BMI and complications in surgery for acoustic neuroma (AN). Study Design Retrospective review. Setting: Two tertiary otology referral institutions. Subjects and Methods Patients undergoing surgery for AN. Univariate and multivariate analysis of association between BMI and complications was performed using two-tailed t tests and binary logistic regression. Results BMI ranged from 18.0 kg/m2 to 63.9 kg/m2 with mean of 29.2 kg/m2 among 362 included patients. High BMI was associated with increased risk of cerebrospinal fluid (CSF) leak ( p = 0.003) and need for revision surgery within 6 months ( p = 0.03). CSF leak occurred in 11.6% of obese patients (BMI ≥ 30.0) and 5.1% of patients with BMI < 30.0. There was no association between BMI and post-operative intracranial hemorrhage, wound infection, or incomplete resection ( p > 0.05). Multivariate analysis revealed BMI was associated with CSF leak (odds ratio 1.11 per BMI point, p = 0.002) and need for revision surgery (odds ratio 1.07 per BMI point, p = 0.02) independent of age, gender, tumor size, or surgical approach. Conclusions The largest series to date investigating BMI in acoustic surgery is presented. Elevated BMI is strongly associated with CSF leak and need for revision surgery but not with other complications. Obese or overweight patients undergoing acoustic neuroma resection should be counseled of their increased risk of CSF leak.

Implications of Obesity on Endoscopic Sinus Surgery Postoperative Complications: An Analysis of the NSQIP Database

“…Similar to otologic procedures, in sinonasal surgery, soft tissue dissection is typically limited, and bony landmarks are largely preserved. These features are likely to account for the limited influence that BMI has on operative time 34 . This principle holds true with neck procedures, albeit to a lesser degree due to the larger capacity for soft tissue accumulation in the neck.…”

“…These features are likely to account for the limited influence that BMI has on operative time. 34 This principle holds true with neck procedures, albeit to a lesser degree due to the larger capacity for soft tissue accumulation in the neck. While surgeons may be required to adapt their approach as a consequence of body habitus, with appropriate planning, operative time should not be greatly altered.…”

Endoscopic Endonasal Eustachian Tube Obliteration for Cerebrospinal Fluid Rhinorrhea: A Case Series and Scoping Review

“…Various factors have been inconsistently associated with increased CSF leak risk after lateral skull base surgery—BMI, male gender, tumor size, functional status, combined approaches, or length of surgery. 10,22-27 Most of the patients in our scoping review were female—in both failed and revision subsets. BMI was only reported in our retrospective series and averaged 23.9 kg/m 2 (SD ± 4.9).…”

Risk Factors for 30-day Postoperative Surgical Site Hematoma Requiring Evacuation After Resection of Brain Metastases

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