Meningitis complicating transsphenoidal hypophysectomy.

The case records of 98 patients who underwent a transsphenoidal hypophysectomy between 1969 and 1979 were examined to establish the frequency of postoperative cerebrospinal rhinorrhea and meningitis. There were seven cases of rhinorrhea and six of meningitis following the procedure. Five of the six patients with meningitis had diabetes mellitus and three of the seven with rhinorrhea had meningitis; thus, both diabetes and rhinorrhea were established as significant risk factors (P less than 0.001) in the development of meningitis after this operation. There were two proven cases of meningitis due to anaerobic organisms and a further two suspected cases. The prophylactic use of antibiotics did not prevent the development of meningitis in this series of patients.