TY - JOUR
T1 - Retrospective Review of Surgical Site Infections after Endoscopic Endonasal Sellar and Parasellar Surgery
T2 - Multicenter Quality Data from the North American Skull Base Society
AU - Saleh, Sara
AU - Sullivan, Stephen E.
AU - Bellile, Emily
AU - Roxbury, Christopher
AU - Das, Paramita
AU - Hachem, Ralph Abi
AU - Ackall, Feras
AU - Jang, David
AU - Celtikci, Emrah
AU - Sahin, Muammer Melih
AU - D'Souza, Glen
AU - Evans, James J.
AU - Nyquist, Gurston
AU - Khalafallah, Adham
AU - Mukherjee, Debraj
AU - Rowan, Nicholas R.
AU - Camp, Samantha
AU - Choby, Garret
AU - Gompel, Jamie J.Van
AU - Ghiam, Michael K.
AU - Levine, Corinna G.
AU - Field, Melvin
AU - Adappa, Nithin
AU - Locke, Tran B.
AU - Rassekh, Christopher
AU - Sweis, Auddie M.
AU - Goyal, Neerav
AU - Zacharia, Brad
AU - Wilson, Meghan N.
AU - Patel, Shivam
AU - Gardner, Paul A.
AU - Snyderman, Carl H.
AU - Wang, Eric W.
AU - Glancz, Laurence Johann
AU - Bagchi, Ananyo
AU - Dow, Graham
AU - Robertson, Iain
AU - Rangarajan, Sanjeet V.
AU - Michael, L. Madison
AU - McKean, Erin L.
N1 - Publisher Copyright:
© 2022 GeorgThieme.
PY - 2022/12
Y1 - 2022/12
N2 - Introduction ?Transnasal access to the anterior skull base provides a minimally invasive approach for sellar and parasellar masses compared with 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. Methods ?We conducted a multicenter retrospective analysis of shared quality data points for the endoscopic endonasal approach (EEA) for pituitary adenomas, along with other sellar and parasellar region masses that were included by participating institutions. Patient and operative characteristics, perioperative and postoperative antibiotic regimens and their durations, intraoperative and postoperative cerebrospinal fluid leak, and onset of postoperative meningitis and sinusitis were compared. Results ?Fifteen institutions participated and provided 6 consecutive months' worth of case data. Five hundred ninety-three cases were included in the study, of which 564 were pituitary adenomectomies. The incidences of postoperative meningitis and sinusitis were low (0.67 and 2.87% for all pathologies, respectively; 0.35% meningitis for pituitary adenomas) and did not correlate with any specific antibiotic regimen. Immunocompromised status posed an increased odds of meningitis in pituitary adenomectomies (28.6, 95% confidence interval [1.72-474.4]). Conclusions ?The results show no clear benefit to postoperative antimicrobial use in EEA, with further larger studies needed.
AB - Introduction ?Transnasal access to the anterior skull base provides a minimally invasive approach for sellar and parasellar masses compared with 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. Methods ?We conducted a multicenter retrospective analysis of shared quality data points for the endoscopic endonasal approach (EEA) for pituitary adenomas, along with other sellar and parasellar region masses that were included by participating institutions. Patient and operative characteristics, perioperative and postoperative antibiotic regimens and their durations, intraoperative and postoperative cerebrospinal fluid leak, and onset of postoperative meningitis and sinusitis were compared. Results ?Fifteen institutions participated and provided 6 consecutive months' worth of case data. Five hundred ninety-three cases were included in the study, of which 564 were pituitary adenomectomies. The incidences of postoperative meningitis and sinusitis were low (0.67 and 2.87% for all pathologies, respectively; 0.35% meningitis for pituitary adenomas) and did not correlate with any specific antibiotic regimen. Immunocompromised status posed an increased odds of meningitis in pituitary adenomectomies (28.6, 95% confidence interval [1.72-474.4]). Conclusions ?The results show no clear benefit to postoperative antimicrobial use in EEA, with further larger studies needed.
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U2 - 10.1055/a-1865-3202
DO - 10.1055/a-1865-3202
M3 - Review article
C2 - 36393885
AN - SCOPUS:85137400803
SN - 2193-634X
VL - 83
SP - 579
EP - 588
JO - Journal of Neurological Surgery, Part B: Skull Base
JF - Journal of Neurological Surgery, Part B: Skull Base
IS - 6
ER -