OSA: Special suspected in spontaneous cerebrospinal fluid leakage

Objectives: Loss of Cerebrospinal Fluid (CSF-L) results from a rupture of the skull base and overlying meninges, and pathological communication between the subarachnoid space and the nasal or middle ear cavity. Recently, the pathogenesis has been linked with Intracranial Hypertension (IIH), elevated Body Mass Index (BMI) and Obstructive Sleep Apnea (OSA). Methods: A single institution retrospective study was conducted on 14 patients from our spontaneous CSFL series, which included 167 patients over a 15-year period from 2004 to 2019. All patients underwent to home respiratory polygraphy. Epidemiological and clinical data were reviewed. For the statistical analysis, the confidence interval for a proportion was defined, according to the methods described by RG Newcombe. Results: 14 patients, previously operated on duraplasty in our ENT department, were enrolled. They underwent to polygraphy. The data were compared with those derived from the literature and the results are neither in the range of the general population nor in the non-spontaneous CSFL. Conclusion: OSA can increase Intracranial Pressure (ICP) and thus spontaneous CSF losses. However, OSA and BMI may not be independent. Therefore, further studies are needed to analyze the data in detail.