Surgical management of spontaneous middle cranial fossa defects: a systematic review and meta-analysis of available reconstructive techniques and materials

Porto, Edoardo; Sun, Hanyao; Revuelta-Barbero, J. Manuel; Pradilla, Iván; Palacios-Ariza, María Alejandra; Velasquez, Nathalia; Garzón-Muvdi, Tomás; Solares, C. Arturo; Mattox, Douglas E.; Vivas, Esther; Pradilla, Gustavo

doi:10.1007/s10143-023-01947-z

Cited by 2 publications

(2 citation statements)

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“…Although this meta‐analysis can add on drawing trends and identifying hypotheses for further research, the overall result should be cautiously interpreted, considering the poor quality of data retrieved, mostly consisting of case series and case‐control studies. Taking into consideration the unanticipated very low frequency of recurrence reported, the possibility of reporting bias and under reported complications and recurrences cannot be safely excluded 32 . Multicenter large, controlled trials can shed light regarding the risk factors of sCSF leaks and best treatment algorithm, keeping in mind the difficulty of conducting double blinded trials in surgical theatres 33 …”

Section: Discussionmentioning

confidence: 99%

“…Taking into consideration the unanticipated very low frequency of recurrence reported, the possibility of reporting bias and under reported complications and recurrences cannot be safely excluded. 32 Multicenter large, controlled trials can shed light regarding the risk factors of sCSF leaks and best treatment algorithm, keeping in mind the difficulty of conducting double blinded trials in surgical theatres. 33 Another issue arising from the studies involved was that often authors used interchangeably the term "patient" as synonymous to operative case, while the same studies included patients with bilateral disease with both ears registered as separate patients in their results section.…”

Section: Limitationsmentioning

confidence: 99%

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The Association Between Obesity and Spontaneous Temporal Bone CSF Leak Outcomes: A Systematic Review and Meta‐Analysis

Spinos,

Geropoulos,

Vavoulis

et al. 2024

The Laryngoscope

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ObjectiveWe undertook a systematic review of the literature with meta‐analysis to identify the role of obesity (BMI ≥30) in the patient characteristics presenting with spontaneous cerebrospinal fluid (sCSF) leaks of the lateral skull base and the outcomes of their repair.Data SourcesA Systematic Review of English Articles using MEDLINE, EMBASE, and Cochrane Library.Review MethodsThe research algorithm included the following keywords: “spontaneous CSF leak,” “lateral skull base,” “temporal bone,” “meningocele,” “encephalocele,” and “otorrhea.” We also manually searched the references of included studies, to identify possible studies missed during our literature search.ResultsMore than two‐thirds of the patients were female (69.2%) and often were obese (mean BMI 36.5 kg/m2) with a mean age of 57. Most common presenting symptoms were otorrhea and hearing loss. Most authors did not report a routine use of a post‐operative lumbar drain. Most patients had a single skull base defect and encephaloceles prolapsing through, across obese and non‐obese groups. Median length of stay in hospital was 3.2 days, and the majority of patients did not have any recurrence during their follow‐up (89.6%), which was not affected by obesity.ConclusionObesity does not affect length of hospital stay or recurrence rate following surgical repair of lateral skull base sCSF leaks. Surgical repair is a safe and viable approach in the management of obese patients with sCSF leaks in the temporal bone.Level of EvidenceN/A Laryngoscope, 2024

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Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%