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

Published online by Cambridge University Press:  21 October 2024

Paul Nix Open the ORCID record for Paul Nix [Opens in a new window]
Paul Nix*
Affiliation:
Department of ENT, Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds, LS13EX, UK
*
Corresponding author: Paul Nix; Email: [email protected]
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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.

Keywords

anterior skull base surgeryendoscopic nasal surgeryepistaxisrhinologyskull base surgery
Type
Main Article
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 3
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Paul Nix takes responsibility for the integrity of the content of the paper

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