09-10, 09:15–09:30 (Europe/Istanbul), Otology 6
Background
Spontaneous cerebrospinal fluid (sCSF) leaks of the temporal bone are increasingly recognized as a manifestation of underlying systemic pathology, particularly obstructive sleep apnea (OSA) and idiopathic intracranial hypertension (IIH). These conditions are associated with increased intracranial pressure (ICP) and calvarial thinning. Therefore, appropriate workup and management of these associated comorbid conditions is imperative to prevent repair failure and address the root causes of the dehiscence.
Description
This presentation outlines a diagnostic and therapeutic approach for associated comorbidities in the sCSF leak patient. It details the preoperative workup, including the role of polysomnography (PSG), and indications for postoperative lumbar puncture (LP). The session will cover the management of comorbid conditions. By viewing sCSF leaks as a symptom of a broader obesity-related systemic disorder, this presentation provides neurotologists with the tools to implement a multidisciplinary treatment plan that extends beyond the operating room to promote long-term surgical success and optimal patient outcomes.
Outcome Objectives
Upon completion of this session, participants will be able to:
Identify the key demographic and comorbid risk factors for sCSF leaks, including the high prevalence of OSA and elevated intracranial pressure.
Formulate a comorbid workup protocol that patients complete necessary evaluation and management for their associated conditions.
Implement a long-term management strategy that incorporates treatment of comorbid conditions to improve patient outcomes and minimize recurrence.
Dr. Evan Cumpston is a neurotologist and Skull base surgeon at Indiana University School of Medicine Department of Otolaryngology—Head and Neck Surgery. His expertise encompasses the removal of benign tumors, such as vestibular schwannomas (acoustic neuromas), meningiomas, paragangliomas (glomus tumors), facial nerve tumors, and cholesterol granulomas. He also has expertise in removing malignant tumors involving the temporal bone, such as squamous cell carcinoma.
In addition, Dr. Cumpston specializes in surgeries for hearing loss, including cochlear implant surgery and stapes surgery. He also performs repairs for cerebrospinal fluid (CSF) leak repairs, disorders of the facial nerve, and surgery for chronic ear disease.
Dr. Cumpson's research is dedicated to enhancing hearing outcomes for cochlear implant recipients and optimizing clinical outcomes in skull base surgeries. He is the director of the IU Otolaryngology Temporal Bone Course and is passionate about medical education, mentoring medical students, residents, and fellows.