{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:10:31Z","timestamp":1791875431912,"version":"4.3.4"},"reference-count":61,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2023,5,28]],"date-time":"2023-05-28T00:00:00Z","timestamp":1685232000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To review the literature and our institutional experience regarding the risk of meningitis in patients with spontaneous lateral skull base cerebrospinal fluid (sCSF) leaks awaiting surgical repair, and the roles of antibiotic prophylaxis and pneumococcal vaccination, if known.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective chart review and systematic review of the literature was undertaken to identify the incidence of meningitis in patients with sCSF leaks awaiting surgical repair. Adults managed surgically for sCSF leaks at an academic tertiary care center over a 10-year period were included. Data was collected on receipt of prophylactic antibiotics and\/or pneumococcal vaccines during the timeframe between diagnosis and surgical repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Institutional review identified 87 patients who underwent surgical repair of spontaneous leaks, with a 0% incidence of meningitis over a median duration of 2\u2009months while awaiting surgery (mean 5.5\u2009months, range 0.5-118\u2009months). Eighty-eight percent of patients did not receive prophylactic antibiotics. No studies in the published literature demonstrated the impact of prophylactic antibiotics or pneumococcal vaccine on meningitis risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>There appears to be a low risk of meningitis among patients with lateral skull base sCSF leaks awaiting surgery for short durations (\u22642\u2009months), even in the absence of prophylactic antibiotics. There is a substantial gap in the published literature assessing the risk of meningitis and roles of antibiotics and vaccination in this patient population, indicating the need for large-scale study to conclusively elucidate the nature of this risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00034894231177756","type":"journal-article","created":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T01:23:52Z","timestamp":1685323432000},"page":"1600-1609","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Meningitis Risk and Role of Prophylactic Antibiotics in Spontaneous Lateral Skull Base CSF Leaks"],"prefix":"10.1177","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4864-8917","authenticated-orcid":false,"given":"Alexandra E.","family":"Quimby","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head & Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1076-1941","authenticated-orcid":false,"given":"Emma","family":"De Ravin","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Eliades","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head & Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason A.","family":"Brant","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head & Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Bigelow","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head & Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Ruckenstein","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head & Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,5,28]]},"reference":[{"key":"bibr1-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.11.036"},{"key":"bibr2-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.134.5.509"},{"key":"bibr3-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1177\/000348949009901102"},{"key":"bibr4-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24251"},{"key":"bibr5-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318271c312"},{"key":"bibr6-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31815937a6"},{"key":"bibr7-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318268d350"},{"key":"bibr8-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28421"},{"issue":"8","key":"bibr9-00034894231177756","first-page":"733","volume":"141","author":"Bakhsheshian J","year":"2015","journal-title":"Otolaryngol Head Neck Surg"},{"key":"bibr10-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003736"},{"issue":"6","key":"bibr11-00034894231177756","first-page":"513","volume":"144","author":"Rabbani C","year":"2018","journal-title":"Otolaryngol Head Neck Surg"},{"key":"bibr12-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001805"},{"key":"bibr13-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000552"},{"key":"bibr14-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2012.01.011"},{"issue":"6","key":"bibr15-00034894231177756","first-page":"765","volume":"16","author":"May JS","year":"1995","journal-title":"Am J Otol"},{"key":"bibr16-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318157f7b6"},{"key":"bibr17-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1177\/000348940711601206"},{"key":"bibr18-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200007000-00019"},{"key":"bibr19-00034894231177756","author":"Eljamel M","year":"1993","journal-title":"The Role of Surgery and Beta-2-transferrin in the Management of Cerebrospinal Fluid Fistula"},{"key":"bibr20-00034894231177756","doi-asserted-by":"publisher","DOI":"10.3109\/02688699308995072"},{"issue":"4","key":"bibr21-00034894231177756","volume":"2015","author":"Ratilal BO","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr22-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1086\/514666"},{"key":"bibr23-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1995.tb00023.x"},{"key":"bibr24-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1016\/0163-4453(93)92126-H"},{"key":"bibr25-00034894231177756","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1997.01900070093016"},{"key":"bibr26-00034894231177756","doi-asserted-by":"publisher","DOI":"10.3109\/02688699008992759"},{"key":"bibr27-00034894231177756","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-104-1-1"},{"key":"bibr28-00034894231177756","doi-asserted-by":"publisher","DOI":"10.2807\/esm.10.09.00564-en"},{"key":"bibr29-00034894231177756","unstructured":"Centers for Disease Control and Prevention. 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