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Meningitis complicating transsphenoidal hypophysectomy
Abstract:
The case records of 98 patients who underwent a transsphenoidal hypophysectomy between 1969 and 1979 were examined to establish the frequency of postoperative cerebrospinal rhinorrhea and meningitis. There were seven cases of rhinorrhea and six of meningitis following the procedure. Five of the six patients with meningitis had diabetes mellitus and three of the seven with rhinorrhea had meningitis; thus, both diabetes and rhinorrhea were established as significant risk factors (P less than 0.001) in the development of meningitis after this operation. There were two proven cases of meningitis due to anaerobic organisms and a further two suspected cases. The prophylactic use of antibiotics did not prevent the development of meningitis in this series of patients.
Insights
Postoperative cerebrospinal fluid (CSF) leaks and meningitis following transsphenoidal hypophysectomy are significant risks. Diabetes mellitus and CSF leaks are identified as key risk factors for developing meningitis after this surgery.
Area of Science:
- Neurosurgery
- Infectious Disease Epidemiology
Background:
- Transsphenoidal hypophysectomy is a surgical procedure to remove the pituitary gland.
- Postoperative complications, including cerebrospinal fluid (CSF) leaks and meningitis, can occur.
Purpose of the Study:
- To determine the incidence of cerebrospinal rhinorrhea and meningitis after transsphenoidal hypophysectomy.
- To identify risk factors associated with meningitis following this procedure.
Main Methods:
- Retrospective review of 98 patient records who underwent transsphenoidal hypophysectomy between 1969 and 1979.
- Analysis of complication rates, specifically CSF rhinorrhea and meningitis.
Main Results:
- Seven cases of cerebrospinal rhinorrhea and six cases of meningitis were recorded.
- Diabetes mellitus (5/6 meningitis cases) and cerebrospinal rhinorrhea (3/7 meningitis cases) were significant risk factors for meningitis (P < 0.001).
- Two confirmed and two suspected cases of anaerobic meningitis were noted.
Conclusions:
- Cerebrospinal rhinorrhea and diabetes mellitus are significant risk factors for meningitis post-transsphenoidal hypophysectomy.
- Prophylactic antibiotics did not prevent meningitis in this patient cohort.