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J Neurol Surg B Skull Base 2012; 73(06): 401-404
DOI: 10.1055/s-0032-1329618
Original Article
Georg Thieme Verlag KG Stuttgart · New York

The Association of Meningitis with Postoperative Cerebrospinal Fluid Fistula

Kyle P. Allen
1   University of Texas Southwestern Medical Center, Department of Otolaryngology, Head and Neck Surgery, Dallas, Texas, USA
,
Brandon Isaacson
1   University of Texas Southwestern Medical Center, Department of Otolaryngology, Head and Neck Surgery, Dallas, Texas, USA
,
J. Walter Kutz
1   University of Texas Southwestern Medical Center, Department of Otolaryngology, Head and Neck Surgery, Dallas, Texas, USA
,
Patricia L. Purcell
2   Division of Head and Neck Surgery, University of Washington, Department of Otolaryngology, Seattle, Washington, USA
,
Peter S. Roland
1   University of Texas Southwestern Medical Center, Department of Otolaryngology, Head and Neck Surgery, Dallas, Texas, USA
› Author Affiliations
Further Information

Publication History

21 November 2011

13 August 2012

Publication Date:
05 November 2012 (online)

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Abstract

Objective To determine the risk factors for and the clinical course of postoperative meningitis following lateral skull base surgery and to determine its relationship to cerebrospinal fluid (CSF) fistula.

Patients Patients undergoing lateral skull base surgery between July 1999 and February 2010 at an academic tertiary referral center. All subjects had culture-proven meningitis or suspected bacterial meningitis in the postoperative period. Medical records were compared with the lateral skull base patients who did not develop meningitis.

Results Of 508 procedures, 16 patients developed meningitis (3.1%). The most common diagnosis was acoustic neuroma in 81.3%; 68.8% of patients had a CSF leak prior to onset of meningitis, and 50% received a lumbar drain. The median time from surgery to the onset of meningitis was 12 days with a range of 2 to 880 days. The relative risk of developing meningitis in the setting of postoperative CSF fistula is 10.2 (p <0.0001). No meningitis-associated mortality was observed.

Conclusions Postoperative meningitis occurred in a small number of patients undergoing lateral skull base surgery. A postoperative CSF fistula leads to an increased risk of meningitis by a factor of 10.2.

Keywords

meningitis - postoperative meningitis - acoustic neuroma
 

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