Shew Matthew, Muelleman Thomas, Harris Michael, Li Michael, Sykes Kevin, Staecker Hinrich, Adunka Oliver Fr, Lin James
1 University of Kansas Department of Otolaryngology-Head and Neck Surgery, Kansas City, Kansas, USA.
2 The Ohio State University Department of Otolaryngology-Head and Neck Surgery, Columbus, Ohio, USA.
Ann Otol Rhinol Laryngol. 2018 Sep;127(9):604-607. doi: 10.1177/0003489418781934. Epub 2018 Jun 21.
Multiple investigators have sought to identify risk factors for cerebrospinal fluid (CSF) leak following cerebellopontine angle (CPA) tumor resection. We evaluated whether pneumatization of the petrous apex (PA) is a risk factor for CSF fistula.
We conducted a retrospective chart review at 2 major tertiary academic institutions undergoing CPA tumor resection and analyzed their respective head or temporal computed tomography (CT) scans if available.
A total of 91 cases were identified; 51 (64%) demonstrated PA pneumatization, and a total of 17 CSF leaks were identified. We discovered higher rates of CSF leak (25.0% vs 13.7%; P = .273) and CSF rhinorrhea (15.0% vs 5.9%; P = .174) in patients with PA pneumatization compared to those without PA pneumatization.
Isolated PA pneumatization may be a risk factor and communication pathway for CSF fistula. Further studies will need to be broadened across multiple institutions to draw any additional and stronger conclusions.
