Diagnosis and treatment of intracranial infection after endoscopic transsphenoidal surgery

Abstract

Objective To discuss the diagnosis and treatment of intracranial infection after endoscopic transsphenoidal surgeries. Methods From January 2011 to January 2013, 459 patients undergoing endoscopic transsphenoidal surgery were analyzed.9 patients (2.0%) developed intracranial infection. 9 patients treated by CSF lumbar drainage and intravenous vancomycin and meropenem treatment. At the same time, CSF and cranial CT were monitored. 2 of 9 patients were healed by intravenous vancomycin and meropenem and CSF lumbar drainage. Other 7 patients were healed by endoscopic transphenoidal repair of CSF leakage, intrathecal and intravenous injection of vancomycin and meropenem alternately (One case developed subdural empyema and treated by key-hole drainage meanwhile). Results All 9 patients were healed according to the above-mentioned methods. During the follow-up period between 12 and 24 months, 8 patients recovered well without any complication. One patient suffered from hydrocephalus after 6 months and healed by V-P shunt. Conclusion The treatment of endoscopic transphenoidal repair of CSF leakage, CSF lumbar drainage, intravenous and intrathecal injection of vancomycin and meropenem were effective for intracranial infection after endoscopic transsphenoidal surgery. Key words: Endoscopy; Transphenoidal surgery; Intracranial infection