What is the risk of meningitis, utilising a single agent, single dose peri-operative antibiotic following endonasal endoscopic repair of a CSF leak?

IF 0.8 4区医学 Q3 OTORHINOLARYNGOLOGY Journal of Laryngology and Otology Pub Date : 2025-03-01 DOI:10.1017/S0022215124001609

Paul Nix

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Abstract

Objectives: Endoscopic endonasal surgery of the skull base carries the risk of meningitis. However, no consensus on the prophylactic antibiotic regimen exists.

Methods: A prospectively held database documenting endoscopic endonasal repair of cerebrospinal fluid (CSF) leaks in the anterior skull base was reviewed. Post-operative meningitis and antibiotic usage within 30 days of the index procedure were recorded.

Results: A total of 285 consecutive cases were identified with a post-operative meningitis rate of 3.5 per cent. The post-operative confirmed bacterial meningitis rate was 2 per cent. All cases received a single dose of a single agent antibiotic peri-operatively.The risk of developing post-operative meningitis was associated with a post-operative CSF leak in cases undergoing tumour resection of the anterior skull base.

Conclusion: A single dose, single agent peri-operative antibiotic regimen would appear to be adequate following an endoscopic endonasal approach to repair a CSF leak in the anterior skull base.

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使用单剂、单剂量围手术期抗生素进行脑脊液渗漏内窥镜修复术后发生脑膜炎的风险有多大？

目的：颅底鼻内窥镜手术有发生脑膜炎的危险。然而，对预防性抗生素治疗方案尚无共识。方法：回顾了前颅底脑脊液（CSF）泄漏的内镜下鼻内修复的前瞻性数据库。记录术后30天内的脑膜炎和抗生素使用情况。结果：共确诊285例连续病例，术后脑膜炎发生率为3.5%，术后确认细菌性脑膜炎发生率为2%。所有病例围手术期均接受单剂量单药抗生素治疗。在前颅底肿瘤切除术的病例中，发生术后脑膜炎的风险与术后脑脊液泄漏有关。结论：单剂量，单药围手术期抗生素方案似乎是足够的后内镜鼻内入路修复脑脊液泄漏在前颅底。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Laryngology and Otology 医学-耳鼻喉科学

CiteScore

3.20

自引率

11.80%

发文量

593

审稿时长

3-6 weeks

期刊介绍： The Journal of Laryngology & Otology (JLO) is a leading, monthly journal containing original scientific articles and clinical records in otology, rhinology, laryngology and related specialties. Founded in 1887, JLO is absorbing reading for ENT specialists and trainees. The journal has an international outlook with contributions from around the world, relevant to all specialists in this area regardless of the country in which they practise. JLO contains main articles (original, review and historical), case reports and short reports as well as radiology, pathology or oncology in focus, a selection of abstracts, book reviews, letters to the editor, general notes and calendar, operative surgery techniques, and occasional supplements. It is fully illustrated and has become a definitive reference source in this fast-moving subject area. Published monthly an annual subscription is excellent value for money. Included in the subscription is access to the JLO interactive web site with searchable abstract database of the journal archive back to 1887.