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Updated: Feb 8, 2026

Sample Preparation for Endopeptidomic Analysis in Human Cerebrospinal Fluid
Published on: December 4, 2017
Petrous Apex Pneumatization: Influence on Postoperative Cerebellopontine Angle Tumor Cerebrospinal Fluid Fistula
Matthew Shew1, Thomas Muelleman1, Michael Harris2
11 University of Kansas Department of Otolaryngology-Head and Neck Surgery, Kansas City, Kansas, USA.
Objective:
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.
Method:
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.
Results:
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.
Conclusions:
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.
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