CSF rhinorrhoea after endonasal intervention to the skull base (CRANIAL): A multicentre prospective observational study
dc.contributor.author | Khan, DZ | |
dc.contributor.author | Marcus, HJ | |
dc.contributor.author | Bandyopadhyay, S | |
dc.contributor.author | Schroeder, BE | |
dc.contributor.author | Patel, V | |
dc.contributor.author | O'Donnell, A | |
dc.contributor.author | Giamouriadis, A | |
dc.contributor.author | Bhatt, P | |
dc.contributor.author | Ram, B | |
dc.contributor.author | Varma, A | |
dc.contributor.author | Weir, P | |
dc.contributor.author | Hanna, B | |
dc.contributor.author | Hirst, TC | |
dc.contributor.author | McAleavey, P | |
dc.contributor.author | Paluzzi, A | |
dc.contributor.author | Tsermoulas, G | |
dc.contributor.author | Ahmed, S | |
dc.contributor.author | Soon, WC | |
dc.contributor.author | Chowdhury, YA | |
dc.contributor.author | Abualsaud, S | |
dc.contributor.author | Mahmood, S | |
dc.contributor.author | Naik, P | |
dc.contributor.author | Haiderkhan, Z | |
dc.contributor.author | Al-Mahfoudh, R | |
dc.contributor.author | Perera, A | |
dc.contributor.author | Rus, M | |
dc.contributor.author | Williams, A | |
dc.contributor.author | Hand, C | |
dc.contributor.author | Abhinav, K | |
dc.contributor.author | Cernei, C | |
dc.contributor.author | Dilnawaz, A | |
dc.contributor.author | Mannion, R | |
dc.contributor.author | Santarius, T | |
dc.contributor.author | Tysome, J | |
dc.contributor.author | Sharma, R | |
dc.contributor.author | Kolias, AG | |
dc.contributor.author | Donnelly, N | |
dc.contributor.author | Venkatesh, A | |
dc.contributor.author | Hayhurst, C | |
dc.contributor.author | Mohamed, A | |
dc.contributor.author | Stew, B | |
dc.contributor.author | Merola, J | |
dc.contributor.author | Ooi, SZY | |
dc.contributor.author | Kamel, M | |
dc.contributor.author | Khan, MH | |
dc.contributor.author | Abrar, S | |
dc.contributor.author | Mckeon, C | |
dc.contributor.author | McSweeney, D | |
dc.contributor.author | Javadpour, M | |
dc.contributor.author | Lacy, P | |
dc.contributor.author | Murray, D | |
dc.contributor.author | Roman, E | |
dc.contributor.author | Hossain-Ibrahim, K | |
dc.contributor.author | Ross, P | |
dc.contributor.author | Bennett, D | |
dc.contributor.author | McSorley, N | |
dc.contributor.author | Hounat, A | |
dc.contributor.author | Statham, P | |
dc.contributor.author | Hughes, M | |
dc.contributor.author | Hamdan, A | |
dc.contributor.author | Scott, C | |
dc.contributor.author | Moudgil-Joshi, J | |
dc.contributor.author | Bahl, A | |
dc.contributor.author | Bjornson, A | |
dc.contributor.author | Gatt, D | |
dc.contributor.author | Phillips, N | |
dc.contributor.author | Kalra, N | |
dc.contributor.author | Bautista, M | |
dc.contributor.author | Shirazi, S | |
dc.contributor.author | Gilkes, CE | |
dc.contributor.author | Millward, CP | |
dc.contributor.author | Ali, AM | |
dc.contributor.author | Paraskevopoulos, D | |
dc.contributor.author | Bal, J | |
dc.contributor.author | Matloob, S | |
dc.contributor.author | Lobo, R | |
dc.contributor.author | Mendoza, N | |
dc.contributor.author | Nair, R | |
dc.contributor.author | Dalton, A | |
dc.contributor.author | Nadig, A | |
dc.contributor.author | Hernandez, L | |
dc.contributor.author | Thomas, N | |
dc.contributor.author | Maratos, E | |
dc.contributor.author | Shapey, J | |
dc.contributor.author | Al-Barazi, S | |
dc.contributor.author | Mirza, AB | |
dc.contributor.author | Okasha, M | |
dc.contributor.author | Malhotra, PS | |
dc.contributor.author | Ahmed, R | |
dc.contributor.author | Dorward, NL | |
dc.contributor.author | Grieve, J | |
dc.contributor.author | Sayal, P | |
dc.contributor.author | Choi, D | |
dc.contributor.author | Cabrilo, I | |
dc.contributor.author | Horsfall, HL | |
dc.contributor.author | Pollock, J | |
dc.contributor.author | Shoakazemi, A | |
dc.contributor.author | Maccormac, O | |
dc.contributor.author | Amirthalingam, GNK | |
dc.contributor.author | Martin, A | |
dc.contributor.author | Stapleton, S | |
dc.contributor.author | Hogg, F | |
dc.contributor.author | Richardson, D | |
dc.contributor.author | Gnanalingham, K | |
dc.contributor.author | Pathmanaban, O | |
dc.contributor.author | Fountain, DM | |
dc.contributor.author | Bhalla, R | |
dc.contributor.author | Hannan, CJ | |
dc.contributor.author | Chadwick, A | |
dc.contributor.author | Jenkins, A | |
dc.contributor.author | Nicholson, C | |
dc.contributor.author | Shumon, S | |
dc.contributor.author | Youssef, M | |
dc.contributor.author | Allison, C | |
dc.contributor.author | Dow, G | |
dc.contributor.author | Robertson, I | |
dc.contributor.author | Glancz, LJ | |
dc.contributor.author | Sitaraman, M | |
dc.contributor.author | Kumaria, A | |
dc.contributor.author | Bagchi, A | |
dc.contributor.author | Cudlip, S | |
dc.contributor.author | Halliday, J | |
dc.contributor.author | Piper, RJ | |
dc.contributor.author | Boukas, A | |
dc.contributor.author | Amarouche, M | |
dc.contributor.author | Veljanoski, D | |
dc.contributor.author | Muquit, S | |
dc.contributor.author | Edlmann, E | |
dc.contributor.author | Maripi, H | |
dc.contributor.author | Wang, Y | |
dc.contributor.author | Hossain, M | |
dc.contributor.author | Alalade, A | |
dc.contributor.author | Maroof, S | |
dc.contributor.author | Patkar, P | |
dc.contributor.author | Sinha, S | |
dc.contributor.author | Mirza, S | |
dc.contributor.author | Henderson, D | |
dc.contributor.author | Khan, MS | |
dc.contributor.author | Mathad, N | |
dc.contributor.author | Hempenstall, J | |
dc.contributor.author | Wang, D | |
dc.contributor.author | Marwaha, P | |
dc.contributor.author | Shaw, S | |
dc.contributor.author | Solomou, G | |
dc.contributor.author | Shrestha, A | |
dc.contributor.author | Fraser, A | |
dc.contributor.author | Hirst, T | |
dc.contributor.author | Chowdhury, Y | |
dc.contributor.author | Bilal, S | |
dc.contributor.author | Wildman, J | |
dc.contributor.author | Babu, P | |
dc.contributor.author | Carey, C | |
dc.contributor.author | Bathuni, RR | |
dc.contributor.author | Brennan, JN | |
dc.contributor.author | Trichinopoly, ST | |
dc.contributor.author | Khan, D | |
dc.contributor.author | Sobawale, S | |
dc.contributor.author | Suliman, A | |
dc.contributor.author | Piper, R | |
dc.contributor.author | Owen, W | |
dc.contributor.author | Sartaj, A | |
dc.contributor.author | Goacher, E | |
dc.contributor.author | Strachan, E | |
dc.contributor.author | Solomou, G | |
dc.contributor.author | Ktayen, H | |
dc.contributor.author | Consortium, CRANIAL | |
dc.date.accessioned | 2023-10-16T12:05:49Z | |
dc.date.available | 2023-10-16T12:05:49Z | |
dc.date.issued | 2023-01-04 | |
dc.identifier.issn | 2234-943X | |
dc.identifier.issn | 2234-943X | |
dc.identifier.other | ARTN 1049627 | |
dc.identifier.uri | https://pearl.plymouth.ac.uk/handle/10026.1/21433 | |
dc.description.abstract |
<jats:sec><jats:title>Objective</jats:title><jats:p>Despite progress in endonasal skull-base neurosurgery, cerebrospinal fluid (CSF) rhinorrhoea remains common and significant. The CRANIAL study sought to determine 1) the scope of skull-base repair methods used, and 2) corresponding rates of postoperative CSF rhinorrhoea in the endonasal transsphenoidal approach (TSA) and the expanded endonasal approach (EEA) for skull-base tumors.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A prospective observational cohort study of 30 centres performing endonasal skull-base neurosurgery in the UK and Ireland (representing 91% of adult units). Patients were identified for 6 months and followed up for 6 months. Data collection and analysis was guided by our published protocol and pilot studies. Descriptive statistics, univariate and multivariable logistic regression models were used for analysis.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 866 patients were included - 726 TSA (84%) and 140 EEA (16%). There was significant heterogeneity in repair protocols across centres. In TSA cases, nasal packing (519/726, 72%), tissue glues (474/726, 65%) and hemostatic agents (439/726, 61%) were the most common skull base repair techniques. Comparatively, pedicled flaps (90/140, 64%), CSF diversion (38/140, 27%), buttresses (17/140, 12%) and gasket sealing (11/140, 9%) were more commonly used in EEA cases. CSF rhinorrhoea (biochemically confirmed or requiring re-operation) occurred in 3.9% of TSA (28/726) and 7.1% of EEA (10/140) cases. A significant number of patients with CSF rhinorrhoea (15/38, 39%) occurred when no intraoperative CSF leak was reported. On multivariate analysis, there may be marginal benefits with using tissue glues in TSA (OR: 0.2, CI: 0.1-0.7, p&lt;0.01), but no other technique reached significance. There was evidence that certain characteristics make CSF rhinorrhoea more likely – such as previous endonasal surgery and the presence of intraoperative CSF leak.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>There is a wide range of skull base repair techniques used across centres. Overall, CSF rhinorrhoea rates across the UK and Ireland are lower than generally reported in the literature. A large proportion of postoperative leaks occurred in the context of occult intraoperative CSF leaks, and decisions for universal sellar repairs should consider the risks and cost-effectiveness of repair strategies. Future work could include longer-term, higher-volume studies, such as a registry; and high-quality interventional studies.</jats:p></jats:sec> | |
dc.format.extent | 1049627- | |
dc.format.medium | Electronic-eCollection | |
dc.language | eng | |
dc.publisher | Frontiers Media SA | |
dc.subject | cerebrospinal fluid rhinorrhoea | |
dc.subject | CSF | |
dc.subject | EEA | |
dc.subject | endoscopic endonasal | |
dc.subject | cerebrospinal fluid leak | |
dc.subject | skull base surgery | |
dc.title | CSF rhinorrhoea after endonasal intervention to the skull base (CRANIAL): A multicentre prospective observational study | |
dc.type | Journal Article | |
plymouth.author-url | https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000928239800001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008 | |
plymouth.volume | 12 | |
plymouth.publication-status | Published online | |
plymouth.journal | Frontiers in Oncology | |
dc.identifier.doi | 10.3389/fonc.2022.1049627 | |
plymouth.organisational-group | |Plymouth | |
plymouth.organisational-group | |Plymouth|Research Groups | |
plymouth.organisational-group | |Plymouth|Faculty of Health | |
plymouth.organisational-group | |Plymouth|REF 2021 Researchers by UoA | |
plymouth.organisational-group | |Plymouth|Users by role | |
plymouth.organisational-group | |Plymouth|Users by role|Academics | |
plymouth.organisational-group | |Plymouth|REF 2021 Researchers by UoA|UoA01 Clinical Medicine | |
plymouth.organisational-group | |Plymouth|Faculty of Health|Peninsula Medical School | |
plymouth.organisational-group | |Plymouth|Research Groups|FoH - Applied Parkinson's Research | |
plymouth.organisational-group | |Plymouth|Users by role|Researchers in ResearchFish submission | |
plymouth.organisational-group | |Plymouth|Research Groups|Plymouth Institute of Health and Care Research (PIHR) | |
dc.publisher.place | Switzerland | |
dcterms.dateAccepted | 2022-10-24 | |
dc.date.updated | 2023-10-16T12:05:48Z | |
dc.rights.embargodate | 2023-10-17 | |
dc.identifier.eissn | 2234-943X | |
rioxxterms.versionofrecord | 10.3389/fonc.2022.1049627 |