Risk Factors in a Pediatric Population for Postoperative Intracranial Infection Following Endoscopic Endonasal Skull Base Surgery and the Role of Antibiotic Prophylaxis

Autor:	Daniel Palmieri, Pierre-Olivier Champagne, Benita Valappil, Michael M. McDowell, Paul A. Gardner, Carl H. Snyderman
Rok vydání:	2022
Předmět:	Male Skull Base Adolescent Cerebrospinal Fluid Leak Infant Endoscopy General Medicine Antibiotic Prophylaxis Postoperative Complications Otorhinolaryngology Risk Factors Child Preschool Humans Immunology and Allergy Female Meningitis Child Retrospective Studies
Zdroj:	American Journal of Rhinology & Allergy. 37:13-18
ISSN:	1945-8932 1945-8924
Popis:	Background Endoscopic endonasal skull base surgery (EESBS) is performed through a non-sterile corridor. Intracranial infection rates in a pediatric population have not been extensively studied and the exact effect of antibiotic prophylaxis on rates of infection after EESBS in pediatric patients remains unclear. Objective The purpose of our study is to investigate risk factors for postoperative intracranial infection during EESBS in a pediatric population and help elucidate the role of antibiotic prophylaxis. Methods We conducted a retrospective chart review of 99 consecutive patients under the age of 18 who underwent EESBS at our institution from 2013 to 2021. Centers for Disease Control and Prevention/National Healthcare Safety Network criteria for diagnosis of meningitis were used to identify postoperative intracranial infections. Results The average age was 12.3 years (range 1.6-18) with 66 male patients and 33 female patients. 49 patients had an intraoperative cerebrospinal fluid (CSF) leak, of which 4 had a postoperative CSF leak. We identified 3 postoperative intracranial infections (3%), which were all meningitis cases. The infection rate was 6% (3/49) among those with intraoperative CSF leaks. All patients with meningitis had a postoperative CSF leak. All infections were transclival approaches (2 chordoma and 1 neurenteric cyst). Conclusion This investigation represents one of the largest pediatric endoscopic skull base surgery cohorts. EESBS is safe to perform in pediatric populations, but transclival approaches and postoperative CSF leaks are risk factors for postoperative meningitis.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b2ad71de4da4c5ad1cee28cd0520fb1e https://doi.org/10.1177/19458924221123113 Zobrazit plný text záznamu