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1 results

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

  • Paul Nix
  • Journal:
    The Journal of Laryngology & Otology , First View
    Published online by Cambridge University Press:
    21 October 2024, pp. 1-3
  • 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.