2025 Poster Presentations
P271: GLOBAL PREVALENCE, RECURRENCE, AND RISK FACTORS ASSOCIATED WITH SPONTANEOUS CSF RHINORRHEA - A SYSTEMATIC REVIEW AND META-ANALYSIS
Srivatsa Surya Vasudevan, MD, MS; Amir Kaskas, MD; Michael Yim, MD; LSU Health Shreveport
Background: Spontaneous CSF (sCSF) leaks can be intermittent and challenging to diagnose. There is a gap in the literature regarding its prevalence, recurrence rates and the prevalent risk factors associated.
Methods: PubMed, Embase, Web of Science, and ScienceDirect were systematically searched for studies related to sCSF rhinorrhea. We performed a proportional random effect model meta-analysis to estimate the pooled effect sizes of risk factors, prevalence, and recurrence rates associated with sCSF leak
Results: From a total of 444 studies, 40 studies were included, comprising 3154 CSF rhinorrhea patients. The prevalence rate of sCSF leaks among overall CSF rhinorrhea patients was estimated to be 29.9% (95% CI: 23.3% - 37.5%) (Figure 1). The recurrence rate of sCSF leaks was 14% (95% CI: 7.3% - 25.3%) (Figure 2). The prevalence of risk factors associated with sCSF leaks varied among different conditions. Obesity had the highest association with sCSF leaks, with a prevalence rate of 67.0% (95% CI: 41.2% - 85.5%). Hypertension also showed a significant association, with a prevalence rate of 53.4% (95% CI: 46.0% - 62.5%). Empty sella was identified as a notable risk factor with a prevalence rate of 59.3% (95% CI: 35.7% - 79.3%). Diabetes was associated with a prevalence rate of 28.2% (95% CI: 20.5% - 37.5%). Obstructive sleep apnea (OSA) had a prevalence of 21.7% (95% CI: 12.5% - 35.2%), while a prior history of meningitis was associated with a prevalence of 15.5% (95% CI: 9.2% - 24.9%).
Conclusion: Our systematic review reported the significant prevalence rates associated with sCSF leaks among patients with CSF rhinorrhea, with a notable association between obesity, hypertension, and empty sella as prevalent risk factors. This study also highlights the recurrence of sCSF rhinorrhea following CSF leak repair.
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