title: Body mass index predicts risk for complications from transtemporal cerebellopontine angle surgery.
abstract: OBJECTIVE
  To determine the relationship between body mass index (BMI) and risk for specific complications from transtemporal cerebellopontine angle (CPA) surgery for nonmalignant disease.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary-care academic hospital.
  
  
  METHODS
  Retrospective review of 134 consecutive patients undergoing transtemporal cerebellopontine angle surgery for nonmalignant disease from 2009 to 2011. Data were collected regarding demographics, body mass index, intraoperative details, hospital stay, and complications including cerebrospinal fluid leak, wound complications, and brachial plexopathy.
  
  
  RESULTS
  One hundred thirty-four patients were analyzed with a mean preoperative body mass index of 28.58. Statistical analysis demonstrated a significant difference in body mass index between patients with a postoperative cerebrospinal fluid leak and those without (P = .04), as well as a similar significant difference between those experiencing postoperative brachial plexopathy and those with no such complication (P = .03). Logistical regression analysis confirmed that body mass index is significant in predicting both postoperative cerebrospinal fluid leak (P = .004; odds ratio, 1.10) and brachial plexopathy (P = .04; odds ratio, 1.07). Elevated body mass index was not significant in predicting wound complications or increased hospital stay beyond postoperative day 3.
  
  
  CONCLUSIONS
  Risk of cerebrospinal fluid leak and brachial plexopathy is increased in patients with elevated body mass index undergoing surgery of the cerebellopontine angle. Consideration should be given to preoperative optimization via dietary and lifestyle modifications as well as intraoperative somatosensory evoked potential monitoring of the brachial plexus to decrease these risks.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Loyola University of Chicago Stritch School of Medicine, Maywood, Illinois 60153, USA.
authors.forename: Avinash V
authors.initials: AV
authors.lastname: Mantravadi
authors.forename: John P
authors.initials: JP
authors.lastname: Leonetti
authors.forename: Ryan
authors.initials: R
authors.lastname: Burgette
authors.forename: George
authors.initials: G
authors.lastname: Pontikis
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Marzo
authors.forename: Douglas
authors.initials: D
authors.lastname: Anderson
mesh_terms: D015992:Body Mass Index; D020516:Brachial Plexus Neuropathies / Q000209:etiology; D002530:Cerebellopontine Angle / Q000601:surgery*; D065634:Cerebrospinal Fluid Leak; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology; D005073:Evoked Potentials, Somatosensory; D006801:Humans; D016015:Logistic Models; D009765:Obesity / Q000150:complications; D011183:Postoperative Complications; D012189:Retrospective Studies; D012306:Risk