Review articleBariatric surgery as a treatment for idiopathic intracranial hypertension: a systematic review
Section snippets
Protocol and registration
This review was conducted in accordance with the widely accepted PRISMA 2009 protocol, which is openly available from a number of sources. This review was registered through the PROSPERO Systematic Review Data Repository (SRDR) initiative (available at http://www.crd.york.ac.uk/PROSPERO); the registration number is CRD42015020446.
Eligibility criteria
Studies in all languages were considered, and searches also included material that had not been formally published (grey literature) such as conference proceedings.
Search criteria
Study selection and characteristics
A total of 85 papers were screened, and 17 were included in the final review. Of these, 6 studies and 11 case reports were found involving a total of 67 patients. Two larger studies that investigated the effects of bariatric surgery on various co-morbidities of obesity, including IIH, were excluded, because they did not include any postoperative data on changes in symptoms of IIH [14], [15]. Two additional review papers were also acknowledged and assimilated; however, these did not contain any
Discussion
Michaelides et al. [31] conducted a retrospective study by searching 2 databases of>2000 patients to find 16 females with morbid obesity and pulsatile tinnitus who had undergone bariatric surgery. While the main endpoint was resolution of pulsatile tinnitus, this symptom was assumed to be secondary to PTC syndrome and arguably took a more pragmatic approach toward symptom control rather than simply a reduction in ICP. Fundoscopy and LP performed in 12 of these patients were able to confirm
Conclusion
To our knowledge, this is the first published systematic review that examines the role of bariatric surgery as a treatment for IIH. It also builds upon 2 previous review articles through the addition of a number of further studies and case reports. What can reliably be concluded from this systematic review is that bariatric surgery has been shown to be successful and even superior to other treatments of IIH with high failure rates associated with conventional therapies such as weight loss by
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
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