Audiologic improvement following MCF approach for spontaneous cerebrospinal fluid leaks

Mohamedkazim Alwani, Elhaam Bandali, Lauren Van Buren, Charles Yates, Rick Nelson

Research output: Contribution to journalArticle

Abstract

Objective: To determine the audiologic improvement after middle cranial fossa (MCF) approach to repair spontaneous cerebrospinal fluid (sCSF) leaks. Study Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: Twenty-four consecutive patients (27 ears) with temporal bone sCSF leak over a 4-year period. Patient age, sex, ethnicity, body mass index (BMI), location of CSF leak, recurrence of CSF leak, and presence of encephalocele(s) were recorded. Intervention: Audiometric testing in patients undergoing MCF repair of temporal bone sCSF leak. Main Outcome Measures: Comparison of preoperative and postoperative pure-tone average (PTA), air-bone gap (ABG), and word recognition score (WRS) in the sCSF leak ear. Results: Out of 27 ears, 55% had multiple tegmen defects and 82% had more than or equal to 1 encephaloceles. There were no recurrent CSF leaks at a median follow up of 4 months. The mean (SD) preoperative PTA and ABG were 40.58 [15.67] and 16.44 [6.93] dB, respectively. There was significant improvement in mean PTA (10.28 [8.01] dB; p < 0.001; Cohen d ¼ 0.95) and ABG (9.31 [7.16] dB; p < 0.001; Cohen d ¼ 0.88) after sCSF repair. Mean WRS improved (by 3.07 [6.11] %; p ¼ 0.024; Cohen d ¼ 0.46) from a mean preoperative WRS of 93.16 [9.34]% to a mean postoperative WRS of 96.26 [6.49]%. Conclusions: MCF approach for repair of sCSF leaks yields significant improvement in conductive hearing loss and is highly effective in management of the entire lateral skull base where multiple bony defects are often identified.

Original languageEnglish (US)
Pages (from-to)1026-1033
Number of pages8
JournalOtology and Neurotology
Volume40
Issue number8
DOIs
StatePublished - Sep 1 2019

Fingerprint

Middle Cranial Fossa
Encephalocele
Ear
Temporal Bone
Air
Bone and Bones
Conductive Hearing Loss
Skull Base
Tertiary Care Centers
Cerebrospinal Fluid
Body Mass Index
Cohort Studies
Retrospective Studies
Outcome Assessment (Health Care)
Cerebrospinal Fluid Leak
Recurrence

Keywords

  • Air-bone gap
  • Audiogram
  • Cerebrospinal fluid
  • Cerebrospinal fluid leak
  • Hearing loss
  • Lateral skull base
  • Obstructive sleep apnea
  • Spontaneous
  • Temporal bone

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

Audiologic improvement following MCF approach for spontaneous cerebrospinal fluid leaks. / Alwani, Mohamedkazim; Bandali, Elhaam; Van Buren, Lauren; Yates, Charles; Nelson, Rick.

In: Otology and Neurotology, Vol. 40, No. 8, 01.09.2019, p. 1026-1033.

Research output: Contribution to journalArticle

Alwani, Mohamedkazim ; Bandali, Elhaam ; Van Buren, Lauren ; Yates, Charles ; Nelson, Rick. / Audiologic improvement following MCF approach for spontaneous cerebrospinal fluid leaks. In: Otology and Neurotology. 2019 ; Vol. 40, No. 8. pp. 1026-1033.
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abstract = "Objective: To determine the audiologic improvement after middle cranial fossa (MCF) approach to repair spontaneous cerebrospinal fluid (sCSF) leaks. Study Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: Twenty-four consecutive patients (27 ears) with temporal bone sCSF leak over a 4-year period. Patient age, sex, ethnicity, body mass index (BMI), location of CSF leak, recurrence of CSF leak, and presence of encephalocele(s) were recorded. Intervention: Audiometric testing in patients undergoing MCF repair of temporal bone sCSF leak. Main Outcome Measures: Comparison of preoperative and postoperative pure-tone average (PTA), air-bone gap (ABG), and word recognition score (WRS) in the sCSF leak ear. Results: Out of 27 ears, 55{\%} had multiple tegmen defects and 82{\%} had more than or equal to 1 encephaloceles. There were no recurrent CSF leaks at a median follow up of 4 months. The mean (SD) preoperative PTA and ABG were 40.58 [15.67] and 16.44 [6.93] dB, respectively. There was significant improvement in mean PTA (10.28 [8.01] dB; p < 0.001; Cohen d ¼ 0.95) and ABG (9.31 [7.16] dB; p < 0.001; Cohen d ¼ 0.88) after sCSF repair. Mean WRS improved (by 3.07 [6.11] {\%}; p ¼ 0.024; Cohen d ¼ 0.46) from a mean preoperative WRS of 93.16 [9.34]{\%} to a mean postoperative WRS of 96.26 [6.49]{\%}. Conclusions: MCF approach for repair of sCSF leaks yields significant improvement in conductive hearing loss and is highly effective in management of the entire lateral skull base where multiple bony defects are often identified.",
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AU - Van Buren, Lauren

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