Retrospective Review of Surgical Site Infections after Endoscopic Endonasal Approaches for Parasellar Masses: A Multicenter Study from the North American Skull Base Society

Transnasal access to the anterior skull base provides a minimally invasive approach for sellar and parasellar masses compared to its open counterparts. The unique microbiome of the sinonasal mucosa provides distinct challenges not encountered with other cranial approaches. The use of antibiotics in these cases has not been standardized, and data remain scarce regarding infectious outcomes. We conducted a multicenter retrospective analysis of endoscopic endonasal approaches for parasellar masses (hereafter EEA) and compared patient characteristics and infectious outcomes, primarily postoperative meningitis and sinusitis. Fifteen institutions participated and provided six consecutive months’ worth of case data. Six hundred five patients were included in the study. Perioperative and postoperative antibiotic regimens, intraoperative and postoperative leak, in addition to patient characteristics, were analyzed. The incidence of postoperative meningitis and sinusitis were low (0.67 and 2.97%, respectively) and did not correlate with any antibiotic regimen. We found that postoperative CSF leak correlated with an increased incidence of postoperative meningitis, and this finding approached significance. The results indicate that no specific antibiotic regimen was found to alter infectious outcomes, and a randomized controlled trial is indicated for antimicrobial stewardship.

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Artikel online veröffentlicht:
15. Februar 2022