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Quantitative analysis of tegmen bone mineral density in obese and non-obese patients

Published online by Cambridge University Press:  01 October 2021

S Holmes*
Affiliation:
Department of Otolaryngology, Ochsner Louisiana State University (‘LSU’) Health Shreveport, Shreveport, USA
A Geimadi
Affiliation:
Department of Radiology, Ochsner Louisiana State University (‘LSU’) Health Shreveport, Shreveport, USA
A Mamilly
Affiliation:
Department of Radiology, Ochsner Louisiana State University (‘LSU’) Health Shreveport, Shreveport, USA
M Hamiter
Affiliation:
Department of Otolaryngology, Ochsner Louisiana State University (‘LSU’) Health Shreveport, Shreveport, USA
H Cuellar
Affiliation:
Department of Radiology, Ochsner Louisiana State University (‘LSU’) Health Shreveport, Shreveport, USA
G Mankekar
Affiliation:
Department of Otolaryngology, Ochsner Louisiana State University (‘LSU’) Health Shreveport, Shreveport, USA
*
Author for correspondence: Dr Sean Holmes, 952 Elmwood St, Shreveport, Louisiana71104, USA E-mail: sholm6@lsuhsc.edu

Abstract

Background

Certain factors have been linked to lateral skull base demineralisation or erosion, which may predispose to spontaneous cerebrospinal fluid leak. There are relatively few quantitative reports of skull base changes in patient populations.

Method

A novel refined measurement algorithm for quantification of tegmen bone mineral density was developed, and bone mineral density between obese and non-obese patient groups was compared. Computed tomography scans were analysed by three blinded reviewers, and tegmen bone mineral densities were compared.

Results

There were 23 patients in the obese group and 27 matched controls in the non-obese group. Inter-rater reliability was ‘strong’ to ‘near complete’ (κ = 0.75–0.86). No differences in tegmen bone mineral density were found between the groups (p = 0.64). The number of active blood pressure medications correlated positively with lateral skull base bone mineral density.

Conclusion

A novel, refined, quantitative measurement algorithm for the assessment of tegmen bone mineral density was developed and validated. Obesity was not found to significantly affect tegmen bone mineral density.

Type
Main Articles
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr S Holmes takes responsibility for the integrity of the content of the paper

References

Hoang, S, Ortiz Torres, MJ, Rivera, AL, Litofsky, NS. Middle cranial fossa approach to repair tegmen defects with autologous or alloplastic graft. World Neurosurg 2018;118:e1017CrossRefGoogle ScholarPubMed
Sönmez, S, Şahin, B, Polat, B, Çomoğlu, Ş, Orhan, KS. Repair of tegmen tympani defect presenting with spontaneous cerebrospinal fluid otorrhea using the middle cranial fossa approach. J Int Adv Otol 2017;13:430–3CrossRefGoogle ScholarPubMed
Phang, SY, Whitehouse, K, Lee, L, Khalil, H, McArdle, P, Whitfield, PC. Management of CSF leak in base of skull fractures in adults. Br J Neurosurg 2016;30:596604CrossRefGoogle ScholarPubMed
Stevens, SM, Lambert, PR, Rizk, H, McIlwain, WR, Nguyen, SA, Meyer, TA. Novel radiographic measurement algorithm demonstrating a link between obesity and lateral skull base attenuation. Otolaryngol Head Neck Surg 2015;152:172–9CrossRefGoogle ScholarPubMed
Schievink, WI, Maya, MM, Jean-Pierre, S, Nuño, M, Prasad, RS, Moser, FG. A classification system of spontaneous spinal CSF leaks. Neurology 2016;87:673–9CrossRefGoogle ScholarPubMed
Nelson, RF, Gantz, BJ, Hansen, MR. The rising incidence of spontaneous cerebrospinal fluid leaks in the United States and the association with obesity and obstructive sleep apnea. Otol Neurotol 2015;36:476–80CrossRefGoogle ScholarPubMed
Handzel, O, Brenner-Ullman, A, Niry, D, Neuman, U, Cavel, O, Ungar, O et al. Tegmen attenuation in patients with idiopathic intracranial hypertension is progressive. Laryngoscope 2020;130:E904–10CrossRefGoogle ScholarPubMed
Taylor, A, van der Meer, G, Perry, D, Best, E, Webb, R. Recurrent pneumococcal meningitis secondary to nasoethmoidal meningocele. Pediatr Infect Dis J 2020;39:e1719CrossRefGoogle ScholarPubMed
Kuo, P, Bagwell, KA, Mongelluzzo, G, Schutt, C, Malhotra, A, Kveton, J et al. Semicircular canal dehiscence among idiopathic intracranial hypertension patients. Laryngoscope 2018;128:1196–9CrossRefGoogle ScholarPubMed
Remenschneider, AK, Kozin, ED, Curtin, H, Santos, F. Histopathology of idiopathic lateral skull base defects. Laryngoscope 2015;125:1798–806CrossRefGoogle ScholarPubMed
Rabbani, CC, Saltagi, MZ, Nelson, RF. The role of obesity, sleep apnea, and elevated intracranial pressure in spontaneous cerebrospinal fluid leaks. Curr Opin Otolaryngol Head Neck Surg 2019;27:349–55CrossRefGoogle ScholarPubMed
Rabbani, C, Saltagi, MZ, Ye, MJ, Patel, JM, Manchanda, S, Nelson, RF. Association of obstructive sleep apnea with calvarial and skull base thinning. JAMA Otolaryngol Head Neck Surg 2018;144:513–18CrossRefGoogle ScholarPubMed
Hatch, JL, Schopper, H, Boersma, IM, Rizk, HG, Nguyen, SA, Lambert, PR et al. The bone mineral density of the lateral skull base and its relation to obesity and spontaneous cerebrospinal fluid leaks. Otol Neurotol 2018;39:e831–6CrossRefGoogle ScholarPubMed
Schreiber, JJ, Anderson, PA, Hsu, WK. Use of computed tomography for assessing bone mineral density. Neurosurg Focus 2014;37:E4CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention. Defining Adult Overweight & Obesity. In: https://www.cdc.gov/obesity/adult/defining.html [28 September 2021]Google Scholar
Rizk, HG, Hatch, JL, Stevens, SM, Lambert, PR, Meyer, TA. Lateral skull base attenuation in superior semicircular canal dehiscence and spontaneous cerebrospinal fluid otorrhea. Otolaryngol Head Neck Surg 2016;155:641–8CrossRefGoogle ScholarPubMed
Shapses, SA, Pop, LC, Wang, Y. Obesity is a concern for bone health with aging. Nutr Res 2017;39:113CrossRefGoogle ScholarPubMed
Barzilay, JI, Davis, BR, Pressel, SL, Ghosh, A, Puttnam, R, Whelton, PK et al. The impact of antihypertensive medications on bone mineral density and fracture risk. Curr Cardiol Rep 2017;19:76CrossRefGoogle Scholar
Zhang, Y, Li, XL, Sha, NN, Shu, B, Zhai, YJ, Wang, YJ et al. Differential response of bone and kidney to ACEI in db/db mice: a potential effect of captopril on accelerating bone loss. Bone 2017;97:222–32CrossRefGoogle ScholarPubMed