[First experiences in endonasal duraplasty without antibiotics]

Area of Science:

• Neurosurgery
• Otolaryngology
• Infectious Disease

Background:

• Evidence does not consistently support prophylactic antibiotics for cerebrospinal fluid (CSF) fistulae.
• The necessity of antibiotic prophylaxis or therapy for operative closure of frontobasal dural lesions remains a question.

Purpose of the Study:

• To evaluate the efficacy and safety of endonasal duraplasty without antibiotic prophylaxis.
• To determine if antibiotic cover is mandatory for operative closure of frontobasal dural lesions.

Main Methods:

• A retrospective survey of 7 patients undergoing endonasal duraplasty without pre- or intraoperative antibiotics.
• Evaluation of hospital course, post-operative complications (including meningitis), need for antibiotic therapy, and diagnostic tests like the fluorescein test.

Main Results:

• 6 out of 7 patients had an uneventful postoperative course without inflammatory complications.
• No meningitis occurred in any patient; all duraplasties were successfully closed.
• One patient received antibiotics post-operatively due to fever; 5 had a negative fluorescein test.

Conclusions:

• Endonasal duraplasty is a satisfactory surgical approach for dural closure.
• Antibiotic prophylaxis may not be essential for endonasal duraplasty in small lesions without specific risk factors.
• Larger patient populations are needed to confirm these findings regarding antibiotic necessity.