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Otolaryngol Head Neck Surg. 2011 Oct;145(4):689-93. doi: 10.1177/0194599811411534. Epub 2011 Jun 9.

Association between cerebrospinal fluid leak and meningitis after skull base surgery.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Abstract

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.

PMID:
21659496
DOI:
10.1177/0194599811411534
[Indexed for MEDLINE]

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