PDF icon PDF herunterladen
Open Access
CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1809357
Original Article

Incidence and Risk Factors of Postoperative Meningitis Following Endoscopic Endonasal Transsphenoidal Surgery: A Study in Thailand

Panu Boontoterm 
1   Neurological Surgery Unit, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
,
Siraruj Sakoolnamarka
2   Advisor of Neurological Surgery Unit, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
,
Karanarak Urasyanandana
1   Neurological Surgery Unit, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
,
Pusit Fuengfoo
3   Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
› Institutsangaben
Funding None.
› Weitere Informationen
Auch verfügbar aufeRef
  Lizenzen und Reprints
Preview

Abstract

Objectives

Postoperative meningitis following endoscopic endonasal transsphenoidal surgery (TSS) is a critical outcome metric. Meningitis is one of the most severe complications in neurosurgery, particularly with transsphenoidal procedures, due to the potential for bacterial contamination from the nasal or sinus cavities. Identifying the risk factors associated with postoperative meningitis is crucial for preventing and minimizing this risk in future surgeries.

Materials and Methods

The study reviewed admission forms, operative notes, and the occurrence of various complications in patients who underwent the TSS approach between 2010 and 2024, focusing on variations in health care access and surgical practices.

Statistical Analysis

Descriptive statistics will summarize demographic, surgical, and clinical characteristics. Univariate analysis: risk factors for meningitis could be evaluated through chi-square tests for categorical variables (e.g., presence of a cerebrospinal fluid [CSF] leak) and t-tests or analysis of variance for continuous variables (e.g., age, surgery duration). Multivariate logistic regression: to identify independent predictors of meningitis, logistic regression could be used.

Results

A total of 237 patients who underwent TSS between 2010 and 2024 were included in the final analysis. The overall incidence of postoperative meningitis was 23%. Intra- and postoperative CSF leakage, diabetes mellitus, obesity, and previous sinus or nasal infection were found to be a significant factor associated with postoperative meningitis.

Conclusion

Understanding the risk factors for meningitis following TSS is crucial for improving patient outcomes. While preoperative nares cleaning with normal saline may reduce nasal congestion, our findings indicate that it does not significantly affect the rate of postoperative meningitis compared with Hibitane-only cleaning.

Keywords

risk factors - endoscopic endonasal surgery - transsphenoidal surgery - postoperative meningitis - neurosurgery

Authors' Contributions

P.B. was responsible for project administration and coordination, drafted the original manuscript, and actively participated in the review process. S.S. contributed to data curation and the review process. Both P.B. and P.F. were involved in data curation, manuscript drafting, and review. Additionally, P.B. and S.S. contributed to data curation, while P.B., P.F., and K.U. collaborated on data curation and formal analysis of the research. P.F. and K.U. were also involved in project administration and coordination, as well as the review process. All authors have reviewed and approved the final version of the manuscript.


Ethical Approval

The study was approved by the Thai Clinical Trials Registry Committee under opinion number TCTR20240509003 on May 9, 2024, and by the Ethics Committee of the Institutional Review Board of the Royal Thai Army Medical Department on December 24, 2021 (Research No. S068h/64). The research adhered to the 2012 Council for International Organizations of Medical Sciences (CIOMS) Guidelines and the Good Clinical Practice (GCP) Guidelines of the International Conference on Harmonization (ICH) (Statement No. IRBRTA 1861/2564). As a retrospective study involving the review of medical records, inpatient department data, and other hospital clinical data that did not allow for patient identification, the study did not involve specific interventions. Written consent was obtained in accordance with the 2012 CIOMS Guidelines and GCP of the ICH, as required for retrospective studies that do not involve direct patient interaction.




Publikationsverlauf

Artikel online veröffentlicht:
26. Mai 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India