Immunisations and antibiotics in patients with anterior skull base cerebrospinal fluid leaks

Rimmer, Joanne; Belk, C; Lund, Valerie J.; Swift, A. C.; White, Paul S.

doi:10.1017/s0022215114001431

Cited by 10 publications

(8 citation statements)

References 11 publications

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“…Choi and Spann studied 1 retrospective cohort that identified a higher incidence of meningitis in patients with basilar skull fractures who received prophylactic antibiotics (12/197) vs those who did not have antibiotics (0/73). Although Rimmer et al . acknowledged that there is a lack of evidence to support prophylactic antibiotics in patients with a CSF leak, they proposed that all patients with an anterior skull base CSF leak at least be immunized against pneumococcus, meningococcus, and haemophilus.…”

Section: Primary Csf Rhinorrheamentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

143

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Section: Primary Csf Rhinorrheamentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

143

279

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“…Größere Erfahrungen liegen bisher jedoch nicht vor [723,724]. Es wurde aktuell zusätzlich zur endoskopischen Duraplastik empfohlen, Patienten mit einer Meningitis bei vermuteter oder nachgewiesener Duraläsion unverzüglich gegen die häufigsten relevanten bakteriellen Erreger (Pneumokokken, Meningokokken, Hämophilus influenzae) impfen zu lassen [168], wobei die Pneumokokkenimpfung die wichtigste darstellt und laut offiziellen Empfehlungen der STIKO bei Liquorfistel indiziert ist (http://www.rki.de/DE/Content/Kommissionen/STIKO/Empfehlungen/Impfempfehlungen_node.html). Nach einer Nasennebenhöhlenoperation sind starke und/oder anhaltende Kopfschmerzen, auch schon am Operationstag, verdächtig hinsichtlich einer Duraläsion und intrakraniellen Komplikation.…”

Section: Duraplastikunclassified

“…einer Woche erreicht [765]. Während eine Antibiotikaprophylaxe bei unkomplizierter Rhinoliquorrhoe/Duraläsion nicht indiziert ist [167,168], wird eine perioperative Antibiotikagabe im Rahmen der Duraplastik allgemein empfohlen. Sie erfolgt solange Nasentamponaden oder eine Lumbaldrainage in situ sind und sollte ausreichend gegen Staphylokokkus aureus wirken [162,164,165].…”

Section: Duraplastikunclassified

Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie

Weber

2015

Laryngo-Rhino-Otol

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Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases.Appropriate frame conditions provided, the respective procedures are safe and successful.These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery.The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinusoperation with extended surgery of the frontal (Draf type III), maxillary (grade 3-4, medial maxillectomy, prelacrimal approach) and sphenoid sinus.In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving.This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment.

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“…The relative importance of antibiotic prophylaxis as well as the selection of the "true" high-risk candidates remain to be defined. 89 However, the Center for Disease Control and Prevention recommends either the pneumococcal conjugate vaccine (PCV13) or the pneumococcal polysaccharide vaccine (PPSV23) for patients with CSF leaks. 90…”

Section: Post-traumatic Csf Leaksmentioning

confidence: 99%

The Role of Surgical Intervention in Traumatic Brain Injury

Adams

Kolias

Hutchinson

2016

Neurosurgery Clinics of North America

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The general consensus to optimize the care for severe TBI patients is management at specialized neurotrauma centers with neurosurgical and neurocritical care support and the use of guidelines-based standardized protocols. Over the last decade, significant efforts have been made to define neurotrauma treatment guidelines. However, it is important to recognize the heterogeneity of TBI and that the "one-size-fits-all approach" may not always be appropriate for these patients. Knowledge synthesis activities in neurotrauma are important to define future research agendas. Clinical and research advances have influenced neurotrauma as it continues to mature into a distinct subspecialty of neurosurgery.

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Immunisations and antibiotics in patients with anterior skull base cerebrospinal fluid leaks

Abstract: There is no evidence to support the use of antibiotic prophylaxis in patients with a cerebrospinal fluid leak. We propose that all such patients are advised to seek immunisation against pneumococcus, meningococcus and haemophilus.

Cited by 10 publications

References 11 publications

ICAR: endoscopic skull‐base surgery

ICAR: endoscopic skull‐base surgery

Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie

The Role of Surgical Intervention in Traumatic Brain Injury

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