Management of inflammatory complications of skull base surgery

Because the contents of the intracranial cavity are exposed to the upper airway, inflammatory complications are the most frequent in skull base surgery. If dura has to be resected and reconstructed with a graft, the risk of inflammatory complications increases. An evaluation of 93 patients with skull base tumors who were operated on at the University of California, Davis Medical Center between July 1982 and March 1992 and had resection and reconstruction of dura is presented. Inflammatory complications developed in 33 (35%) patients. Local wound infection, cerebrospinal fluid leak, and meningitis are by far the most frequent complications. Patients with middle and combined fossae approaches have the highest incidence. Cause, treatment, and prophylaxis of inflammatory complications are discussed.