Evidence mapPaperPMID 42106964Full record

SynthesisOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery2026

Risk Reduction of Recurrent Cerebrospinal Fluid Leaks With Postoperative Intracranial Pressure Management: A Systematic Review.

Prishae Wilson, Madison M Doucette, Ryan Hossain, Bastien A Valencia, Christian J Bernard, Zhen Wang, Mallory Raymond

Abstract readSystematic Review
In one paragraph

Synthesis in Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Prishae WilsonDepartment of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Florida, Jacksonville, Florida, USA.ORCID https://orcid.org/0009-0005-0277-4100
Madison M DoucetteCollege of Medicine, Florida State University, Tallahassee, Florida, USA.
Ryan HossainHerbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA.
Bastien A ValenciaDepartment of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Florida, Jacksonville, Florida, USA.ORCID https://orcid.org/0000-0002-1957-7892
Christian J BernardDepartment of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Florida, Jacksonville, Florida, USA.ORCID https://orcid.org/0009-0003-4455-4822
Zhen WangMayo Clinic Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA.
Mallory RaymondDepartment of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Florida, Jacksonville, Florida, USA.ORCID https://orcid.org/0000-0002-7252-1476

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate whether postoperative intracranial pressure-lowering interventions reduce recurrence of lateral skull base spontaneous cerebrospinal fluid leaks after surgical repair. DATA SOURCES: Ovid MEDLINE, Embase, Cochrane CENTRAL, Web of Science Core Collection, and Scopus were searched from inception through April 7, 2025. REVIEW

methodsThe review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included studies of adults with lateral skull base spontaneous cerebrospinal fluid leaks undergoing primary repair where postoperative intracranial pressure-lowering interventions were specified. Pooled recurrence rates were calculated by intervention type and compared with cohorts that did not receive intracranial pressure-lowering therapy.

resultsThirty-six studies including 687 patients (737 cases) met inclusion criteria. Six comparative cohorts (34 treated, 155 untreated) showed no significant difference in recurrence (risk ratio 1.16, 95% confidence interval [CI]: 0.14-9.76; I

conclusionAvailable evidence does not support universal postoperative intracranial pressure-lowering therapy after lateral skull base spontaneous cerebrospinal fluid leak repair. Limited observational data suggest acetazolamide may be associated with lower recurrence, whereas lumbar drainage has not demonstrated sustained benefit. Given the heterogeneity in patient selection and intervention practices, postoperative management should be individualized. Future prospective studies are needed to better define the role of targeted therapy in high-risk patients.

Indexed as

Cerebrospinal Fluid LeakIntracranial PressurePostoperative ComplicationsHumansRecurrenceSecondary Preventioncerebrospinal fluid leaksintracranial pressurepressure–lowering interventionsrecurrencesurgical management

Identifiers

PMID42106964
PMCPMC13417953

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.