{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:54:23Z","timestamp":1779886463213,"version":"3.53.1"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objectives\u2003Endoscopic endonasal approach (EEA) procedures are inherently contaminated due to direct access through the nasopharyngeal mucosa. The reported rate of postoperative meningitis in EEA procedures is between 0.7 and 10%. Lumbar catheters are used in EEA surgeries to prevent cerebrospinal fluid (CSF) fistulae, but their use is associated with increased infection rates. This study investigated whether there is a difference in rates of postoperative meningitis based on lumbar catheter (LC) utilization.<\/jats:p><jats:p>\n          Methods\u2003We performed a retrospective review of consecutive patients who underwent EEA surgeries between January 2016 and March 2023 at a single institution (Fundaci\u00f3n para la Lucha contra las Enfermedades Neurol\u00f3gicas de la Infancia).<\/jats:p><jats:p>\n          Main Outcome\u2003Incidence of meningitis following EEA surgery with lumbar catheter.<\/jats:p><jats:p>\n          Results\u2003Seventy-two patients were enrolled, median age was 44 years, and 53% were female. The most frequent surgery performed was craniopharyngioma 46% (26 patients). A LC was used in 28 patients. Meningitis was diagnosed in 11 of 72 patients (15.2%), being higher in the LC group (10 patients). The odds ratio for the development of meningitis in the presence of an LC was 23.38 (95% confidence interval, 2.77\u2013123.78; p\u2009&lt;\u20090.004). There was no statistical difference in the reported incidence of meningitis when CSF leak was present.<\/jats:p><jats:p>\n          Conclusion\u2003This study demonstrates an extremely high incidence of meningitis (36%) following EEA procedures when an LC is used. The incidence of meningitis was not significantly associated with CSF leak in our cohort.<\/jats:p>","DOI":"10.1055\/a-2298-0898","type":"journal-article","created":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T23:47:48Z","timestamp":1712101668000},"page":"180-184","source":"Crossref","is-referenced-by-count":2,"title":["Impact of the Lumbar Catheter on the Incidence of Postsurgical Meningitis in the Endoscopic Endonasal Approach"],"prefix":"10.1055","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7912-7810","authenticated-orcid":false,"given":"Luis Patricio","family":"Maskin","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Fundaci\u00f3n para la Lucha contra las Enfermedades Neurol\u00f3gicas de la Infancia, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago E.","family":"Noya","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Fundaci\u00f3n para la Lucha contra las Enfermedades Neurol\u00f3gicas de la Infancia, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Caffaratti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fundaci\u00f3n para la Lucha contra las Enfermedades Neurol\u00f3gicas de la Infancia, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Martina","family":"Echarri","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Fundaci\u00f3n para la Lucha contra las Enfermedades Neurol\u00f3gicas de la Infancia, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Hlavnicka","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Fundaci\u00f3n para la Lucha contra las Enfermedades Neurol\u00f3gicas de la Infancia, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Cervio","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fundaci\u00f3n para la Lucha contra las Enfermedades Neurol\u00f3gicas de la Infancia, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"649","DOI":"10.3109\/02688697.2012.673649","article-title":"The expanding role of endoscopic skull base surgery","volume":"26","author":"A Paluzzi","year":"2012","journal-title":"Br J Neurosurg"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.1097\/01.mlg.0000234933.37779.e4","article-title":"A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap","volume":"116","author":"G Hadad","year":"2006","journal-title":"Laryngoscope"},{"issue":"04","key":"ref3","first-page":"1","article-title":"Does lumbar drainage reduce postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery? A prospective, randomized controlled trial","volume":"131","author":"N T Zwagerman","year":"2018","journal-title":"J Neurosurg"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1055\/s-0032-1331022","article-title":"The efficacy and safety of preoperative lumbar drain placement in anterior skull base surgery","volume":"74","author":"P D Ackerman","year":"2013","journal-title":"J Neurol Surg Rep"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s007010200068","article-title":"Complications of closed continuous lumbar drainage of cerebrospinal fluid","volume":"144","author":"S C A\u00e7ikba\u015f","year":"2002","journal-title":"Acta Neurochir (Wien)"},{"issue":"09","key":"ref7","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1056\/NEJM198403013100903","article-title":"Ventriculostomy-related infections. A prospective epidemiologic study","volume":"310","author":"C G Mayhall","year":"1984","journal-title":"N Engl J Med"},{"issue":"06","key":"ref8","doi-asserted-by":"crossref","first-page":"e34","DOI":"10.1093\/cid\/ciw861","article-title":"2017 Infectious Diseases Society of America's Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis","volume":"64","author":"A R Tunkel","year":"2017","journal-title":"Clin Infect Dis"},{"issue":"09","key":"ref9","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1016\/j.clineuro.2013.05.034","article-title":"Cerebrospinal fluid lactate in post-neurosurgical bacterial meningitis diagnosis","volume":"115","author":"L P Maskin","year":"2013","journal-title":"Clin Neurol Neurosurg"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.jocn.2014.08.009","article-title":"Risk factors for postoperative cerebrospinal fluid leak and meningitis after expanded endoscopic endonasal surgery","volume":"22","author":"M E Ivan","year":"2015","journal-title":"J Clin Neurosci"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"e575","DOI":"10.1016\/j.wneu.2018.06.090","article-title":"The role of the lumbar drain in endoscopic endonasal skull base surgery: a retrospective analysis of 811 cases","volume":"117","author":"C Caggiano","year":"2018","journal-title":"World Neurosurg"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"606","DOI":"10.3389\/fonc.2020.00606","article-title":"Efficacy and safety of intraoperative lumbar drain in endoscopic skull base tumor resection: a meta-analysis","volume":"10","author":"X Guo","year":"2020","journal-title":"Front Oncol"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"47","DOI":"10.3171\/2023.5.JNS222791","article-title":"Risk factors for cerebrospinal fluid leak after extended endoscopic endonasal surgery for adult patients with craniopharyngiomas: a multivariate analysis of 364 cases","volume":"140","author":"N Qiao","year":"2023","journal-title":"J Neurosurg"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1086\/657635","article-title":"One thousand endoscopic skull base surgical procedures demystifying the infection potential: incidence and description of postoperative meningitis and brain abscesses","volume":"32","author":"Y Kono","year":"2011","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"01","key":"ref15","first-page":"18","article-title":"The risk of meningitis following expanded endoscopic endonasal skull base surgery: a systematic review","volume":"75","author":"L T Lai","year":"2014","journal-title":"J Neurol Surg B Skull Base"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1055\/s-0039-1696999","article-title":"Infectious complications of expanded endoscopic transsphenoidal surgery: a retrospective cohort analysis of 100 cases","volume":"81","author":"S J Lee","year":"2020","journal-title":"J Neurol Surg B Skull Base"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s12028-015-0239-1","article-title":"Risk factors for infections related to lumbar drainage in spontaneous subarachnoid hemorrhage","volume":"25","author":"H Liang","year":"2016","journal-title":"Neurocrit Care"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s15010-010-0006-3","article-title":"External ventricular and lumbar drainage-associated meningoventriculitis: prospective analysis of time-dependent infection rates and risk factor analysis","volume":"38","author":"S Scheithauer","year":"2010","journal-title":"Infection"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"229","DOI":"10.3171\/jns.2005.102.2.0229","article-title":"Bacterial meningitis caused by the use of ventricular or lumbar cerebrospinal fluid catheters","volume":"102","author":"R P Schade","year":"2005","journal-title":"J Neurosurg"},{"issue":"04","key":"ref20","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1055\/s-2007-1003924","article-title":"Low complication rates of cranial and craniofacial approaches to midline anterior skull base lesions","volume":"18","author":"J T Kryzanski","year":"2008","journal-title":"Skull Base"}],"container-title":["Journal of Neurological Surgery Part B: Skull Base"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2298-0898.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T22:35:34Z","timestamp":1742942134000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2298-0898"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,2]]},"references-count":19,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2025,3,17]]},"published-print":{"date-parts":[[2025,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2298-0898","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6331","2193-634X"],"issn-type":[{"value":"2193-6331","type":"print"},{"value":"2193-634X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,4,2]]},"published":{"date-parts":[[2024,4,2]]}}}