Risk factors for intracranial infection in surgical patients with suprasellar craniopharyngiomas by an expanded endoscopic endonasal approach:a single-center initial experience.

Abstract

Objective: To explore the risk factors for intracranial infection in surgical patients with suprasellar craniopharyngiomas by an expanded endoscopic endonasal approach (EEEA) in a single-center.

Methods: Forty-one patients with suprasellar craniopharyngiomas were retrospectively recruited. EEEA was applied in all patients. All patients were evaluated for the occurrence of intracranial infection after surgery, and the risk factors of infection were further analyzed. The databases of Pubmed, Web of Science were systematically reviewed to identify the rate of meningitis with suprasellar craniopharyngiomas treated with EETS.

Results: Intracranial infection occurred in 21.95% of patients. Patients who were diagnosed as recurrent tumor presented with significant higher incidence of infection than that in the patients with first surgery (55.56% VS 18.75%, P<0.05). The rate of the third ventricle exposure was 88.89% in nine infected patients, which was significantly higher than 40.63% in uninfected patients (P<0.05). The risk factor for post-surgery infection was the exposure of third ventricle during surgery (P=0.043, OR=10.374). The incidence of EETS meningitis varies from 0% to 30%, and the rate of CSF leak varies from 0% to 58% in previous studies. 23 patients received gentamicin physiological saline irrigation in our study, and only two presented intracranial infection after surgery.

Conclusion: The rate of EETS meningitis varies from 0% to 30% according to previous studies. Opening of the third ventricle during surgery was an independent risk factor for intracranial infection in surgical patients with suprasellar craniopharyngiomas by EEEA. Gentamicin physiological saline irrigation during surgery might prevent postsurgical infection.