[Analysis of risk factors for delayed iatrogenic cerebrospinal fluid otorrhinorrhea]

Objective:To explore the common causes of iatrogenic cerebrospinal fluid（CSF） otorrhinorrhea, and further analyze the risk factors for delayed iatrogenic CSF otorrhinorrhea. Methods:The clinical data of 35 iatrogenic CSF otorrhinorrhea patients in department of Otorhinolaryngology Head and Neck Surgery from January 2010 to January 2020 were retrospectively analyzed. Patients were divided into delayed and non-delayed iatrogenic CSF leak groups, according to the time intervals from medical intervention to CSF leak occurrence. The differences of baseline data, complications and success rate between the two groups were analyzed, and the risk factors of delayed iatrogenic cerebrospinal fluid otorrhinorrhea were further analyzed. Results:Endoscopic sinus surgery （n=11）, transsphenoidal pituitary surgery（n=8）, craniotomy（n=12）, and radiotherapy（n=4） all contribute to iatrogenic CSF otorrhinorrhea. Compared with the non-delayed group, the incidence of meningitis in the delayed group was significantly higher（20% vs 60%, P=0.041）. There were no significant differences in gender, radiation, hypertension, diabetes, and success rate between the two groups. Additionally, binary logistic regression analysis showed that sex, age, history of radiation, hypertension and diabetes, as well as causes of CSF otorrhinorrhea had no association with delayed iatrogenic CSF leakage. Conclusion:Patients with delayed iatrogenic CSF otorrhinorrhea have an increased risk of meningitis. Timely diagnose and intervention with appropriate surgical approach and reconstruction method ensures good clinical outcomes.