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Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
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Global Prevalence, Recurrence, and Risk Factors Associated With Spontaneous CSF Otorrhea-A Meta-analysis.

Srivatsa Surya Vasudevan1, Victor Albornoz1, Sydney Schwab2

  • 1Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|June 12, 2025
PubMed
Summary
This summary is machine-generated.

Spontaneous cerebrospinal fluid (CSF) otorrhea affects 37.8% of patients, with obesity and hypertension being common risk factors. Recurrence rates after surgery are around 10.3%.

Keywords:
idiopathic CSF otorrheaspontaneous CSF leakspontaneous cerebrospinal fluid otorrheategmen dehiscence CSF leaktemporal bone CSF leak

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Area of Science:

  • Neurosurgery
  • Otolaryngology
  • Epidemiology

Background:

  • Spontaneous cerebrospinal fluid (CSF) otorrhea is a condition characterized by leakage of CSF from the nose or ear.
  • Understanding its prevalence, recurrence, and associated risk factors is crucial for effective management.

Purpose of the Study:

  • To determine the prevalence and postsurgical recurrence rates of spontaneous CSF otorrhea.
  • To identify prevalent risk factors associated with spontaneous CSF otorrhea.

Main Methods:

  • A systematic literature search was conducted across PubMed, Embase, Web of Science, and ScienceDirect.
  • A random-effects model meta-analysis was employed to pool data from 24 studies involving 1059 patients.

Main Results:

  • The overall prevalence of spontaneous CSF otorrhea was estimated at 37.8%.
  • Common risk factors included obesity (73.9%), hypertension (63.4%), empty sella (49.3%), and obstructive sleep apnea (OSA) (37.6%).
  • Postsurgical recurrence rate was 10.3%, with OSA and prior meningitis negatively associated with male gender.

Conclusions:

  • This meta-analysis provides the first comprehensive estimates of spontaneous CSF otorrhea prevalence and postsurgical recurrence.
  • Obesity, hypertension, empty sella, and OSA are significant risk factors, with a notable association with female gender.