Incidence and Risk Factors of Postoperative Meningitis Following Endoscopic Endonasal Transsphenoidal Surgery: A Study in Thailand.
| Title: | Incidence and Risk Factors of Postoperative Meningitis Following Endoscopic Endonasal Transsphenoidal Surgery: A Study in Thailand. |
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| Authors: | Boontoterm P; Neurological Surgery Unit, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand.; Sakoolnamarka S; Advisor of Neurological Surgery Unit, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand.; Urasyanandana K; Neurological Surgery Unit, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand.; Fuengfoo P; Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand. |
| Source: | Asian journal of neurosurgery [Asian J Neurosurg] 2025 May 26; Vol. 20 (4), pp. 717-723. Date of Electronic Publication: 2025 May 26 (Print Publication: 2025). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Thieme Medical and Scientific Publishers Pvt. Ltd Country of Publication: India NLM ID: 101564712 Publication Model: eCollection Cited Medium: Print ISSN: 1793-5482 (Print) NLM ISO Abbreviation: Asian J Neurosurg Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Publication: 2022- : UP, India : Thieme Medical and Scientific Publishers Pvt. Ltd.; Original Publication: Mumbai : Medknow Publications and Media Pvt. Ltd. |
| 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.; (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/ ).) |
| Competing Interests: | Conflict of Interest None declared. |
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| Contributed Indexing: | Keywords: endoscopic endonasal surgery; neurosurgery; postoperative meningitis; risk factors; transsphenoidal surgery |
| Entry Date(s): | Date Created: 20251204 Date Completed: 20251204 Latest Revision: 20251206 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12672133 |
| DOI: | 10.1055/s-0045-1809357 |
| PMID: | 41340754 |
| Database: | MEDLINE |
Journal Article