O'Connell Brendan P, Stevens Shawn M, Xiao Christopher C, Meyer Ted A, Schlosser Rodney J
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA.
Otolaryngol Head Neck Surg. 2016 Jun;154(6):1138-44. doi: 10.1177/0194599816630738. Epub 2016 Feb 23.
(1) Determine if patients with anterior fossa spontaneous cerebrospinal fluid (SCSF) leaks demonstrate lateral skull base bone attenuation. (2) Examine the relation between body mass index (BMI; kg/m(2)) and skull base thickness.
Retrospective cohort study.
Tertiary care hospital.
Retrospective review from 2004 to 2013 identified 96 patients with anterior cranial fossa SCSF leaks. A control group was identified from a consecutive series of clinic patients. Controls had no history of chronic sinonasal or temporal bone pathology and were divided according to BMI into nonobese (<30 kg/m(2)) and obese (≥30 kg/m(2)) groups. Composite skull base thickness was calculated for lateral and anterior subsites through predefined points according to previously published protocols.
Thirty-two patients were included in each group. Composite lateral skull base thickness was less in patients with SCSF leaks(0.7 ± 0.1 mm) when compared with nonobese controls (0.8 ± 0.1 mm, P = .004); no differences were apparent when SCSF leaks were compared with obese controls (0.7 ± 0.1 mm, P = .99). A direct relation was observed between anterior skull base and lateral skull base thickness (r = 0.48, P < .0001). An inverse correlation was noted between BMI and lateral skull base (r =-0.40, P < .0001).
Patients with anterior fossa SCSF leaks demonstrate attenuation of the lateral skull base. A significant correlation between anterior skull base thickness and lateral skull base thickness was observed. BMI was inversely related to lateral skull base thickness. Taken together, SCSF leaks are associated with obesity, which appears to be partly responsible for diffuse skull base erosion observed in patients with this condition.
（1）确定前颅窝自发性脑脊液（SCSF）漏患者是否存在侧颅底骨质变薄。（2）研究体重指数（BMI；kg/m²）与颅底厚度之间的关系。
回顾性队列研究。
三级医疗中心。
对2004年至2013年期间的病例进行回顾性分析，确定96例前颅窝SCSF漏患者。从一系列连续的门诊患者中选取对照组。对照组无慢性鼻窦或颞骨病变史，并根据BMI分为非肥胖组（<30 kg/m²）和肥胖组（≥30 kg/m²）。根据先前发表的方案，通过预定义点计算侧颅底和前颅底亚部位的复合颅底厚度。
每组纳入32例患者。与非肥胖对照组（0.8±0.1 mm，P = 0.004）相比，SCSF漏患者的侧颅底复合厚度较小（0.7±0.1 mm）；与肥胖对照组（0.7±0.1 mm，P = 0.99）相比，SCSF漏患者无明显差异。观察到前颅底厚度与侧颅底厚度之间存在直接关系（r = 0.48，P < 0.0001）。BMI与侧颅底厚度呈负相关（r = -0.40，P < 0.0001）。
前颅窝SCSF漏患者存在侧颅底骨质变薄。观察到前颅底厚度与侧颅底厚度之间存在显著相关性。BMI与侧颅底厚度呈负相关。综上所述，SCSF漏与肥胖有关，肥胖似乎是导致该病患者出现弥漫性颅底骨质侵蚀的部分原因。
