Risk for Complications from CPA Surgery due to BMI

Abstract

Objective: To determine the relationship between body mass index (BMI) and risk for complications from transtemporal surgery for non-malignant disease processes of the cerebellopontine angle (CPA). To determine the threshold BMI above which risk is increased.

Method: Retrospective review of 106 patients undergoing transtemporal CPA surgery for non-malignant disease processes from 2010 to 2011 (tertiary-care academic center). Preoperative BMI, approach, hospital stay, and complications including cerebrospinal fluid (CSF) leak, wound complications, and brachial plexopathy. Data were analyzed to determine whether BMI affects postoperative CSF leak, wound infection, or brachial plexopathy.

Results: A total of 106 patients were included, with a mean BMI of 28.17. Statistical analysis demonstrated an increased incidence of CSF leak in patients with a preoperative minimum BMI of 31.4 (rpb = 0.216, df = 101, P < .05). There was no clear relationship between BMI and the development of postoperative wound complications. An increased risk for postoperative brachial plexopathy was found in patients with a BMI > 29.97.

Conclusion: Risk of CSF leak and brachial plexopathy after transtemporal CPA surgery for non-malignant processes are increased in patients with an elevated BMI. Consideration should be given to preoperative dietary/lifestyle modifications and exercise programs and/or perioperative lumbar drain placement and intraoperative upper extremity evoked potential monitoring to decrease these risks.