Elevated intracranial pressure in patients with spontaneous cerebrospinal fluid otorrhea

Authors

  • Kyle P. Allen MD, MPH,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A
    • Send correspondence to Kyle P. Allen MD, MPH Department of Otolaryngology–Head and Neck Surgery, UTSW Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9035. E-mail: kylepallen@gmail.com

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  • Carlos L. Perez MD,

    1. Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A
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  • J. Walter Kutz MD,

  • Deniz Gerecci,

    1. University of Texas Southwestern Medical School, Dallas, Texas, U.S.A
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  • Peter S. Roland MD,

    1. Department of Otolaryngology–Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A
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  • Brandon Isaacson MD

    1. Department of Otolaryngology–Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A
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  • Presented as a poster at the American Academy of Otolaryngology–Head and Neck Surgery Annual Meeting, Washington DC, September9–12, 2012.

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

To determine the prevalence of elevated intracranial hypertension in patients with spontaneous cerebrospinal fluid otorrhea (SCSFO).

Study Design

Case series with chart review at a tertiary care academic medical center following institutional review board approval.

Methods

A retrospective review was performed of patients undergoing operative repair of SCSFO between January 2007 and May 2012.

Results

Thirty-eight patients underwent operative repair of SCSFO. Of these, 22 underwent postoperative lumbar puncture with measurement of opening pressure. The opening pressure was elevated (> 20 cm/H20) in eight patients (36.4%). Preoperative magnetic resonance imaging was available for review by a neuroradiologist in 27 patients. Radiographic evidence of elevated intracranial pressure (ICP) was present in 48.1% of patients.

Conclusion

Elevated ICP is common in patients with SCSFO. However, as only a minority of patients have elevated ICP, it is not the sole factor in the development of SCSFO.

Level of Evidence

4. Laryngoscope, 124:251–254, 2014

Ancillary