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Title: Association between cerebrospinal fluid leak and meningitis after skull base surgery. Author: Horowitz G, Fliss DM, Margalit N, Wasserzug O, Gil Z. Journal: Otolaryngol Head Neck Surg; 2011 Oct; 145(4):689-93. PubMed ID: 21659496. Abstract: BACKGROUND: Meningitis and cerebrospinal fluid (CSF) leak are serious complications of skull base surgery, but whether postoperative CSF leak increases the risk of meningitis is unknown. OBJECTIVE: To evaluate any association between meningitis and CSF leak after open or endoscopic skull base resection. STUDY DESIGN AND SETTING: A retrospective case series with chart review in a tertiary care university-affiliated medical center. METHODS: A total of 156 patients underwent intradural tumor resection in our institution between 1994 and 2009, 135 (86%) via the subcranial approach and 21 (14%) through the expanded endonasal approach. All occurrences of meningitis, brain abscess, and CSF leak had been recorded and were available for analysis. RESULTS: Nine patients (5.7%) had postoperative meningitis, and 3 patients had postoperative CSF leak (1.9%). The risk of meningitis in patients without CSF leak was 4.5% (7/153) compared to 66% (2/3) in those with CSF leak. A statistical analysis revealed a significant association between CSF leak and meningitis, with a relative risk of 14.6 (95% confidence interval, 4.95-42; P = .008). CONCLUSION: Postoperative CSF leak significantly increases the risk of meningitis. Most cases of meningitis after skull base operation are probably associated with lumbar drainage infection or from an obscure leak.[Abstract] [Full Text] [Related] [New Search]