Spontaneous Cerebrospinal Fluid Rhinorrhea: Association with Body Weight and Imaging Data

Raphaële Quatre; Arnaud Attye; Christian Adrien Righini; Emile Reyt; Joris Giai; Sébastien Schmerber; Alexandre Karkas

doi:10.1055/s-0037-1603731

Journal of Neurological Surgery Part B: Skull Base, Inhaltsverzeichnis

J Neurol Surg B Skull Base 2017; 78(05): 419-424
DOI: 10.1055/s-0037-1603731

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Spontaneous Cerebrospinal Fluid Rhinorrhea: Association with Body Weight and Imaging Data

Raphaële Quatre

¹Joseph Fourier University, UFR Medecine, Grenoble, France

²Department of Otolaryngology-Head and Neck Surgery, Grenoble University Hospital, Grenoble, France

,

Arnaud Attye

¹Joseph Fourier University, UFR Medecine, Grenoble, France

³Department of Neuroradiology, Grenoble University Hospital, Grenoble, France

,

Christian Adrien Righini

¹Joseph Fourier University, UFR Medecine, Grenoble, France

²Department of Otolaryngology-Head and Neck Surgery, Grenoble University Hospital, Grenoble, France

,

Emile Reyt

¹Joseph Fourier University, UFR Medecine, Grenoble, France

²Department of Otolaryngology-Head and Neck Surgery, Grenoble University Hospital, Grenoble, France

,

Joris Giai

⁴Department of Epidemiology and Public Health, Grenoble University Hospital, Grenoble, France

⁵Department of Biostatistics, Lyon University Hospital, Lyon, France

⁶Claude Bernard University of Lyon 1, UFR Medecine, University of Lyon, Lyon, France

,

Sébastien Schmerber

¹Joseph Fourier University, UFR Medecine, Grenoble, France

²Department of Otolaryngology-Head and Neck Surgery, Grenoble University Hospital, Grenoble, France

,

Alexandre Karkas

¹Joseph Fourier University, UFR Medecine, Grenoble, France

²Department of Otolaryngology-Head and Neck Surgery, Grenoble University Hospital, Grenoble, France

⁷Department of Otolaryngology-Head and Neck Surgery, Saint-Etienne University Hospital, Saint-Etienne, France

› Institutsangaben

Abstract

Objective Spontaneous cerebrospinal fluid rhinorrhea (SCSFR) might be the only clinical manifestation of idiopathic intracranial hypertension (IIH), which has been historically related to overweight. Our goal was to search for an association between SCSFR and increased body weight on the one hand and SCSFR and imaging findings suggestive of IIH on the other hand.

Materials and Methods We retrospectively collected clinical and radiological data of patients operated on endoscopically for SCSFR in our institution from 1993 to 2013. Analyzed factors were body mass index (BMI), extended sphenoid sinus pneumatization on computed tomography, and empty sella and distention of the optic nerve sheath on magnetic resonance imaging.

Results There were 15 patients: 8 females/7 males; mean age 50 years. Primary surgical success rate was 86.7%. Regarding body weight, 80% were overweight (BMI ≥ 25) versus 32% in the French general population (p < 0.001). Among patients with SCSFR, 20% were obese (BMI ≥ 30) versus 15% in French individuals without SCSFR (p = 0.483). Increased pneumatization of sphenoid sinuses was observed in 92.9 versus 27.5% in the general population (p < 0.0001). Empty sella was found in 46.2 versus 3% in the general population (p < 0.00001). Dilation of the optic nerve sheath was observed in 46.2 versus 15% in the general population (p < 0.01).

Conclusion We found statistically significant associations between SCSFR and overweight, increased pneumatization of sphenoid sinuses, empty sella, and dilation of optic nerve sheath, but not with obesity, which did not have any additional impact of CSF leak than did overweight.

Keywords

spontaneous cerebrospinal fluid rhinorrhea - intracranial pressure - sphenoid sinus - pneumatization - empty sella - optic nerve sheath

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Referenzen

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