BACKGROUND: Meningitis and cerebrospinal fluid (CSF) leak are serious complications of skull base surgery, but whether postoperative CSF leak increases the risk of meningitis is unknown. OBJECTIVE: To evaluate any association between meningitis and CSF leak after open or endoscopic skull base resection. STUDY DESIGN AND SETTING: A retrospective case series with chart review in a tertiary care university-affiliated medical center. METHODS: A total of 156 patients underwent intradural tumor resection in our institution between 1994 and 2009, 135 (86%) via the subcranial approach and 21 (14%) through the expanded endonasal approach. All occurrences of meningitis, brain abscess, and CSF leak had been recorded and were available for analysis. RESULTS: Nine patients (5.7%) had postoperative meningitis, and 3 patients had postoperative CSF leak (1.9%). The risk of meningitis in patients without CSF leak was 4.5% (7/153) compared to 66% (2/3) in those with CSF leak. A statistical analysis revealed a significant association between CSF leak and meningitis, with a relative risk of 14.6 (95% confidence interval, 4.95-42; P = .008). CONCLUSION: Postoperative CSF leak significantly increases the risk of meningitis. Most cases of meningitis after skull base operation are probably associated with lumbar drainage infection or from an obscure leak.
BACKGROUND:Meningitis and cerebrospinal fluid (CSF) leak are serious complications of skull base surgery, but whether postoperative CSF leak increases the risk of meningitis is unknown. OBJECTIVE: To evaluate any association between meningitis and CSF leak after open or endoscopic skull base resection. STUDY DESIGN AND SETTING: A retrospective case series with chart review in a tertiary care university-affiliated medical center. METHODS: A total of 156 patients underwent intradural tumor resection in our institution between 1994 and 2009, 135 (86%) via the subcranial approach and 21 (14%) through the expanded endonasal approach. All occurrences of meningitis, brain abscess, and CSF leak had been recorded and were available for analysis. RESULTS: Nine patients (5.7%) had postoperative meningitis, and 3 patients had postoperative CSF leak (1.9%). The risk of meningitis in patients without CSF leak was 4.5% (7/153) compared to 66% (2/3) in those with CSF leak. A statistical analysis revealed a significant association between CSF leak and meningitis, with a relative risk of 14.6 (95% confidence interval, 4.95-42; P = .008). CONCLUSION:Postoperative CSF leak significantly increases the risk of meningitis. Most cases of meningitis after skull base operation are probably associated with lumbar drainage infection or from an obscure leak.
Authors: Marcus V Ortega Alves; Dianna Roberts; Nicholas B Levine; Franco DeMonte; Ehab Y Hanna; Michael E Kupferman Journal: J Neurol Surg B Skull Base Date: 2014-06-04
Authors: Brett E Youngerman; Jennifer A Kosty; Mina M Gerges; Abtin Tabaee; Ashutosh Kacker; Vijay K Anand; Theodore H Schwartz Journal: Acta Neurochir (Wien) Date: 2020-02-11 Impact factor: 2.216
Authors: Justin Shi; Tokunbo Ayeni; Kathleen Kelly Gallagher; Akash J Patel; Ali Jalali; David J Hernandez; Angela D Haskins; Vlad C Sandulache; Erich M Sturgis; Andrew T Huang Journal: J Neurol Surg B Skull Base Date: 2021-02-22
Authors: Kevin L Li; Christina H Fang; Vivian S Hawn; Vijay Agarwal; Varun R Kshretty; Emily Bellile; Nadeem A Akbar; Erin L McKean; Waleed M Abuzeid; Howard S Moskowitz Journal: J Neurol Surg B Skull Base Date: 2021-02-04