颅盖变薄与前颅底自发性脑脊液漏患者相关。

Calvarium Thinning in Patients with Spontaneous Cerebrospinal Fluid Leaks of the Anterior Skull Base.

机构信息

Department of Otolaryngology - Head and Neck Surgery, Indiana University, Indianapolis, Indiana, U.S.A.

School of Medicine, Indiana University, Indianapolis, Indiana, U.S.A.

出版信息

Laryngoscope. 2021 Jun;131(6):1271-1276. doi: 10.1002/lary.29130. Epub 2020 Sep 23.

DOI:10.1002/lary.29130

PMID:32965699

Abstract

OBJECTIVES/HYPOTHESIS: Patients with spontaneous cerebrospinal fluid leaks (sCSF-L) of the temporal bone have isolated calvarial and skull base thinning that is independent of obesity. This study determines if anterior skull base (ASB) sCSF-L patients also have calvarial thinning.

STUDY DESIGN

Retrospective Cohort Study.

METHODS

This was a retrospective cohort study of ASB sCSF-L patients compared to nonobese (body mass index [BMI] < 30 kg/m ) and obese (BMI ≥ 30) control groups. Twenty-one patients in the ASB sCSF-L group and 25 patients in each control group were included. Calvarium and extracranial zygoma thicknesses were measured bilaterally with blinded, standardized, volumetric analysis.

RESULTS

ASB sCSF-L patients had a mean (SD) age of 50.43 (10.19) years, an average (SD) BMI of 38.81 (8.92) kg/m , and most were female (85.71%). The calvarium in patients with ASB sCSF-L was significantly thinner than the nonobese (2.55 mm [0.77] vs. 2.97 [0.67] mm; P = .006; 95% confidence intervals [CI], 0.12-0.30; Cohen d, 0.58) and obese control groups (2.55 [0.77] vs. 2.92 [0.76] mm; P = .02; 95% CI, 0.05-0.34; Cohen d, 0.66). The calvarium thickness of the nonobese patients was not significantly different from the obese patient controls (2.97 [0.67] vs. 2.92 [0.76] mm, P = .9). The extracranial zygoma was not significantly different among the groups (analysis of variance, P = .33).

CONCLUSIONS

ASB sCSF-L patients have isolated calvarial thinning that is independent of obesity. Like lateral skull base sCSF-L patients, these data suggest that the additional obesity-associated intracranial process contributes to skull thinning.

LEVEL OF EVIDENCE

4 Laryngoscope, 131:1271-1276, 2021.

摘要

目的/假设：患有自发性颞骨脑脊髓液漏（sCSF-L）的患者存在孤立的颅骨和颅底变薄，这与肥胖无关。本研究旨在确定前颅底（ASB）sCSF-L 患者是否也存在颅骨变薄。

研究设计

回顾性队列研究。

方法

这是一项回顾性队列研究，比较了 ASB sCSF-L 患者与非肥胖（体重指数 [BMI] < 30 kg/m ）和肥胖（BMI ≥ 30）对照组。ASB sCSF-L 组纳入 21 例患者，每组纳入 25 例非肥胖和肥胖对照组患者。采用盲法、标准化、容积分析测量双侧颅骨和颅外颧骨厚度。

结果

ASB sCSF-L 患者的平均（SD）年龄为 50.43（10.19）岁，平均（SD）BMI 为 38.81（8.92）kg/m ，大多数为女性（85.71%）。ASB sCSF-L 患者的颅骨明显比非肥胖对照组（2.55 mm [0.77] vs. 2.97 [0.67] mm；P = .006；95%置信区间 [CI]，0.12-0.30；Cohen d，0.58）和肥胖对照组（2.55 [0.77] vs. 2.92 [0.76] mm；P = .02；95% CI，0.05-0.34；Cohen d，0.66）薄。非肥胖患者的颅骨厚度与肥胖患者对照组无显著差异（2.97 [0.67] vs. 2.92 [0.76] mm，P = .9）。各组之间的颅外颧骨无明显差异（方差分析，P = .33）。