|
|
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result sql = Role of perioperative antibiotics in endoscopic skull base surgery.
Role of perioperative antibiotics in endoscopic skull base surgery.char = <;code = 60
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char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = a;code = 97
char = g;code = 103
char = n;code = 110
char = o;code = 111
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = 9;code = 57
char = 0;code = 48
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = c;code = 99
char = l;code = 108
char = u;code = 117
char = d;code = 100
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = p;code = 112
char = i;code = 105
char = t;code = 116
char = u;code = 117
char = i;code = 105
char = t;code = 116
char = a;code = 97
char = r;code = 114
char = y;code = 121
char = ;code = 32
char = t;code = 116
char = u;code = 117
char = m;code = 109
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = (;code = 40
char = 6;code = 54
char = 2;code = 50
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = c;code = 99
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = i;code = 105
char = o;code = 111
char = p;code = 112
char = h;code = 104
char = a;code = 97
char = r;code = 114
char = y;code = 121
char = n;code = 110
char = g;code = 103
char = i;code = 105
char = o;code = 111
char = m;code = 109
char = a;code = 97
char = ;code = 32
char = (;code = 40
char = 9;code = 57
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = p;code = 112
char = h;code = 104
char = a;code = 97
char = l;code = 108
char = o;code = 111
char = c;code = 99
char = e;code = 101
char = l;code = 108
char = e;code = 101
char = ;code = 32
char = (;code = 40
char = 9;code = 57
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = i;code = 105
char = o;code = 111
char = m;code = 109
char = a;code = 97
char = ;code = 32
char = (;code = 40
char = 8;code = 56
char = %;code = 37
char = );code = 41
char = .;code = 46
char = ;code = 32
char = F;code = 70
char = i;code = 105
char = f;code = 102
char = t;code = 116
char = y;code = 121
char = -;code = 45
char = e;code = 101
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = t;code = 116
char = ;code = 32
char = (;code = 40
char = 6;code = 54
char = 4;code = 52
char = %;code = 37
char = );code = 41
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = e;code = 101
char = x;code = 120
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = o;code = 111
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = c;code = 99
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = b;code = 98
char = r;code = 114
char = o;code = 111
char = s;code = 115
char = p;code = 112
char = i;code = 105
char = n;code = 110
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = f;code = 102
char = l;code = 108
char = u;code = 117
char = i;code = 105
char = d;code = 100
char = ;code = 32
char = (;code = 40
char = C;code = 67
char = S;code = 83
char = F;code = 70
char = );code = 41
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = a;code = 97
char = k;code = 107
char = .;code = 46
char = ;code = 32
char = A;code = 65
char = ;code = 32
char = v;code = 118
char = a;code = 97
char = r;code = 114
char = i;code = 105
char = e;code = 101
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = u;code = 117
char = t;code = 116
char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = o;code = 111
char = u;code = 117
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = s;code = 115
char = y;code = 121
char = n;code = 110
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = g;code = 103
char = r;code = 114
char = a;code = 97
char = f;code = 102
char = t;code = 116
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = h;code = 104
char = e;code = 101
char = m;code = 109
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = i;code = 105
char = s;code = 115
char = s;code = 115
char = u;code = 117
char = e;code = 101
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = a;code = 97
char = l;code = 108
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = l;code = 108
char = a;code = 97
char = c;code = 99
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = r;code = 114
char = o;code = 111
char = u;code = 117
char = g;code = 103
char = h;code = 104
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = s;code = 115
char = i;code = 105
char = n;code = 110
char = o;code = 111
char = n;code = 110
char = a;code = 97
char = s;code = 115
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = c;code = 99
char = a;code = 97
char = v;code = 118
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = t;code = 116
char = r;code = 114
char = u;code = 117
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = .;code = 46
char = ;code = 32
char = A;code = 65
char = l;code = 108
char = l;code = 108
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = c;code = 99
char = e;code = 101
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = 2;code = 50
char = 4;code = 52
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = 4;code = 52
char = 8;code = 56
char = ;code = 32
char = h;code = 104
char = o;code = 111
char = u;code = 117
char = r;code = 114
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = s;code = 115
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = l;code = 108
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = b;code = 98
char = i;code = 105
char = o;code = 111
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = b;code = 98
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = n;code = 110
char = s;code = 115
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = :;code = 58
char = ;code = 32
char = c;code = 99
char = e;code = 101
char = f;code = 102
char = a;code = 97
char = z;code = 122
char = o;code = 111
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = (;code = 40
char = 8;code = 56
char = 7;code = 55
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = v;code = 118
char = a;code = 97
char = n;code = 110
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = y;code = 121
char = c;code = 99
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = (;code = 40
char = 1;code = 49
char = 0;code = 48
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = c;code = 99
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = d;code = 100
char = a;code = 97
char = m;code = 109
char = y;code = 121
char = c;code = 99
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = (;code = 40
char = 3;code = 51
char = %;code = 37
char = );code = 41
char = .;code = 46
char = ;code = 32
char = A;code = 65
char = d;code = 100
char = d;code = 100
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = b;code = 98
char = i;code = 105
char = o;code = 111
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = s;code = 115
char = u;code = 117
char = b;code = 98
char = s;code = 115
char = e;code = 101
char = q;code = 113
char = u;code = 117
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = q;code = 113
char = u;code = 117
char = i;code = 105
char = r;code = 114
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = d;code = 100
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = h;code = 104
char = o;code = 111
char = s;code = 115
char = p;code = 112
char = i;code = 105
char = t;code = 116
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = y;code = 121
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = e;code = 101
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = t;code = 116
char = ;code = 32
char = (;code = 40
char = 9;code = 57
char = %;code = 37
char = );code = 41
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = v;code = 118
char = a;code = 97
char = r;code = 114
char = i;code = 105
char = e;code = 101
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = d;code = 100
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = n;code = 110
char = o;code = 111
char = ;code = 32
char = c;code = 99
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = i;code = 105
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = f;code = 102
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = o;code = 111
char = u;code = 117
char = t;code = 116
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = o;code = 111
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = C;code = 67
char = S;code = 83
char = F;code = 70
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = a;code = 97
char = k;code = 107
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = C;code = 67
char = O;code = 79
char = N;code = 78
char = C;code = 67
char = L;code = 76
char = U;code = 85
char = S;code = 83
char = I;code = 73
char = O;code = 79
char = N;code = 78
char = S;code = 83
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = D;code = 68
char = e;code = 101
char = s;code = 115
char = p;code = 112
char = i;code = 105
char = t;code = 116
char = e;code = 101
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = r;code = 114
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = t;code = 116
char = a;code = 97
char = m;code = 109
char = i;code = 105
char = n;code = 110
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = i;code = 105
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = c;code = 99
char = a;code = 97
char = v;code = 118
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = d;code = 100
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = e;code = 101
char = n;code = 110
char = d;code = 100
char = o;code = 111
char = s;code = 115
char = c;code = 99
char = o;code = 111
char = p;code = 112
char = i;code = 105
char = c;code = 99
char = ,;code = 44
char = ;code = 32
char = e;code = 101
char = n;code = 110
char = d;code = 100
char = o;code = 111
char = n;code = 110
char = a;code = 97
char = s;code = 115
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = s;code = 115
char = k;code = 107
char = u;code = 117
char = l;code = 108
char = l;code = 108
char = ;code = 32
char = b;code = 98
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = s;code = 115
char = u;code = 117
char = r;code = 114
char = g;code = 103
char = e;code = 101
char = r;code = 114
char = y;code = 121
char = ,;code = 44
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = r;code = 114
char = i;code = 105
char = s;code = 115
char = k;code = 107
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = C;code = 67
char = N;code = 78
char = S;code = 83
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = f;code = 102
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result sql = OBJECTIVES/HYPOTHESIS : Direct connection between the sinonasal and intracranial cavities and passage of multiple instruments and graft materials through a contaminated field occur routinely during endoscopic pituitary and skull base surgery. Despite the theoretical risk of intracranial contamination with sinonasal flora, the incidence of central nervous system (CNS) infection following such procedures is not well documented, and the ideal antibiotic regimen has yet to be determined.
STUDY DESIGN : Prospective case series of 24 to 48 hours of single-agent perioperative antibiotics in patients undergoing endoscopic skull base surgery.
METHODS : Prospective database of procedures performed between January 2004 and May 2006 was reviewed for antibiotic use and infectious complications.
RESULTS : The diagnoses of the 90 patients in this series included pituitary tumor (62%), craniopharyngioma (9%), encephalocele (9%), and meningioma (8%). Fifty-eight (64%) patients experienced intraoperative cerebrospinal fluid (CSF) leak. A variety of autologous, synthetic grafts, hemostatic agents, and tissue sealants were placed through the sinonasal cavity for reconstruction. All patients received 24 to 48 hours of a single antibiotic based on patient sensitivity: cefazolin (87%), vancomycin (10%), or clindamycin (3%). Additional antibiotics were subsequently required during the hospital stay in eight (9%) patients for a variety of indications. There were no cases of intracranial infections or meningitis in patients with or without intraoperative CSF leak.
CONCLUSIONS : Despite direct contamination of the intracranial cavity during endoscopic, endonasal skull base surgery, the risk of CNS infections is low. Limited use of a single perioperative antibiotic may be sufficient prophylaxis.
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result sql = Role of perioperative antibiotics in endoscopic skull base surgery.
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char = u;code = 117
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = m;code = 109
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = b;code = 98
char = e;code = 101
char = t;code = 116
char = w;code = 119
char = e;code = 101
char = e;code = 101
char = n;code = 110
char = ;code = 32
char = J;code = 74
char = a;code = 97
char = n;code = 110
char = u;code = 117
char = a;code = 97
char = r;code = 114
char = y;code = 121
char = ;code = 32
char = 2;code = 50
char = 0;code = 48
char = 0;code = 48
char = 4;code = 52
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = M;code = 77
char = a;code = 97
char = y;code = 121
char = ;code = 32
char = 2;code = 50
char = 0;code = 48
char = 0;code = 48
char = 6;code = 54
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = v;code = 118
char = i;code = 105
char = e;code = 101
char = w;code = 119
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = b;code = 98
char = i;code = 105
char = o;code = 111
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = u;code = 117
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = f;code = 102
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = u;code = 117
char = s;code = 115
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = p;code = 112
char = l;code = 108
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = R;code = 82
char = E;code = 69
char = S;code = 83
char = U;code = 85
char = L;code = 76
char = T;code = 84
char = S;code = 83
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = a;code = 97
char = g;code = 103
char = n;code = 110
char = o;code = 111
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = 9;code = 57
char = 0;code = 48
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = c;code = 99
char = l;code = 108
char = u;code = 117
char = d;code = 100
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = p;code = 112
char = i;code = 105
char = t;code = 116
char = u;code = 117
char = i;code = 105
char = t;code = 116
char = a;code = 97
char = r;code = 114
char = y;code = 121
char = ;code = 32
char = t;code = 116
char = u;code = 117
char = m;code = 109
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = (;code = 40
char = 6;code = 54
char = 2;code = 50
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = c;code = 99
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = i;code = 105
char = o;code = 111
char = p;code = 112
char = h;code = 104
char = a;code = 97
char = r;code = 114
char = y;code = 121
char = n;code = 110
char = g;code = 103
char = i;code = 105
char = o;code = 111
char = m;code = 109
char = a;code = 97
char = ;code = 32
char = (;code = 40
char = 9;code = 57
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = p;code = 112
char = h;code = 104
char = a;code = 97
char = l;code = 108
char = o;code = 111
char = c;code = 99
char = e;code = 101
char = l;code = 108
char = e;code = 101
char = ;code = 32
char = (;code = 40
char = 9;code = 57
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = i;code = 105
char = o;code = 111
char = m;code = 109
char = a;code = 97
char = ;code = 32
char = (;code = 40
char = 8;code = 56
char = %;code = 37
char = );code = 41
char = .;code = 46
char = ;code = 32
char = F;code = 70
char = i;code = 105
char = f;code = 102
char = t;code = 116
char = y;code = 121
char = -;code = 45
char = e;code = 101
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = t;code = 116
char = ;code = 32
char = (;code = 40
char = 6;code = 54
char = 4;code = 52
char = %;code = 37
char = );code = 41
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = e;code = 101
char = x;code = 120
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = o;code = 111
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = c;code = 99
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = b;code = 98
char = r;code = 114
char = o;code = 111
char = s;code = 115
char = p;code = 112
char = i;code = 105
char = n;code = 110
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = f;code = 102
char = l;code = 108
char = u;code = 117
char = i;code = 105
char = d;code = 100
char = ;code = 32
char = (;code = 40
char = C;code = 67
char = S;code = 83
char = F;code = 70
char = );code = 41
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = a;code = 97
char = k;code = 107
char = .;code = 46
char = ;code = 32
char = A;code = 65
char = ;code = 32
char = v;code = 118
char = a;code = 97
char = r;code = 114
char = i;code = 105
char = e;code = 101
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = u;code = 117
char = t;code = 116
char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = o;code = 111
char = u;code = 117
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = s;code = 115
char = y;code = 121
char = n;code = 110
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = g;code = 103
char = r;code = 114
char = a;code = 97
char = f;code = 102
char = t;code = 116
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = h;code = 104
char = e;code = 101
char = m;code = 109
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = i;code = 105
char = s;code = 115
char = s;code = 115
char = u;code = 117
char = e;code = 101
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = a;code = 97
char = l;code = 108
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = l;code = 108
char = a;code = 97
char = c;code = 99
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = r;code = 114
char = o;code = 111
char = u;code = 117
char = g;code = 103
char = h;code = 104
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = s;code = 115
char = i;code = 105
char = n;code = 110
char = o;code = 111
char = n;code = 110
char = a;code = 97
char = s;code = 115
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = c;code = 99
char = a;code = 97
char = v;code = 118
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = t;code = 116
char = r;code = 114
char = u;code = 117
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = .;code = 46
char = ;code = 32
char = A;code = 65
char = l;code = 108
char = l;code = 108
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = c;code = 99
char = e;code = 101
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = 2;code = 50
char = 4;code = 52
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = 4;code = 52
char = 8;code = 56
char = ;code = 32
char = h;code = 104
char = o;code = 111
char = u;code = 117
char = r;code = 114
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = s;code = 115
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = l;code = 108
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = b;code = 98
char = i;code = 105
char = o;code = 111
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = b;code = 98
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = n;code = 110
char = s;code = 115
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = :;code = 58
char = ;code = 32
char = c;code = 99
char = e;code = 101
char = f;code = 102
char = a;code = 97
char = z;code = 122
char = o;code = 111
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = (;code = 40
char = 8;code = 56
char = 7;code = 55
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = v;code = 118
char = a;code = 97
char = n;code = 110
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = y;code = 121
char = c;code = 99
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = (;code = 40
char = 1;code = 49
char = 0;code = 48
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = c;code = 99
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = d;code = 100
char = a;code = 97
char = m;code = 109
char = y;code = 121
char = c;code = 99
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = (;code = 40
char = 3;code = 51
char = %;code = 37
char = );code = 41
char = .;code = 46
char = ;code = 32
char = A;code = 65
char = d;code = 100
char = d;code = 100
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = b;code = 98
char = i;code = 105
char = o;code = 111
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = s;code = 115
char = u;code = 117
char = b;code = 98
char = s;code = 115
char = e;code = 101
char = q;code = 113
char = u;code = 117
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = q;code = 113
char = u;code = 117
char = i;code = 105
char = r;code = 114
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = d;code = 100
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = h;code = 104
char = o;code = 111
char = s;code = 115
char = p;code = 112
char = i;code = 105
char = t;code = 116
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = y;code = 121
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = e;code = 101
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = t;code = 116
char = ;code = 32
char = (;code = 40
char = 9;code = 57
char = %;code = 37
char = );code = 41
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = v;code = 118
char = a;code = 97
char = r;code = 114
char = i;code = 105
char = e;code = 101
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = d;code = 100
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = n;code = 110
char = o;code = 111
char = ;code = 32
char = c;code = 99
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = i;code = 105
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = f;code = 102
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = o;code = 111
char = u;code = 117
char = t;code = 116
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = o;code = 111
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = C;code = 67
char = S;code = 83
char = F;code = 70
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = a;code = 97
char = k;code = 107
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = C;code = 67
char = O;code = 79
char = N;code = 78
char = C;code = 67
char = L;code = 76
char = U;code = 85
char = S;code = 83
char = I;code = 73
char = O;code = 79
char = N;code = 78
char = S;code = 83
char = ;code = 32
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char = n;code = 110
char = ;code = 32
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char = f;code = 102
char = ;code = 32
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char = ;code = 32
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char = i;code = 105
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char = ;code = 32
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char = ;code = 32
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char = ;code = 32
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char = p;code = 112
char = e;code = 101
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char = e;code = 101
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char = i;code = 105
char = o;code = 111
char = t;code = 116
char = i;code = 105
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char = ;code = 32
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char = ;code = 32
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char = e;code = 101
char = ;code = 32
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char = u;code = 117
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char = f;code = 102
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char = c;code = 99
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
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char = r;code = 114
char = o;code = 111
char = p;code = 112
char = h;code = 104
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result sql = OBJECTIVES/HYPOTHESIS : Direct connection between the sinonasal and intracranial cavities and passage of multiple instruments and graft materials through a contaminated field occur routinely during endoscopic pituitary and skull base surgery. Despite the theoretical risk of intracranial contamination with sinonasal flora, the incidence of central nervous system (CNS) infection following such procedures is not well documented, and the ideal antibiotic regimen has yet to be determined.
STUDY DESIGN : Prospective case series of 24 to 48 hours of single-agent perioperative antibiotics in patients undergoing endoscopic skull base surgery.
METHODS : Prospective database of procedures performed between January 2004 and May 2006 was reviewed for antibiotic use and infectious complications.
RESULTS : The diagnoses of the 90 patients in this series included pituitary tumor (62%), craniopharyngioma (9%), encephalocele (9%), and meningioma (8%). Fifty-eight (64%) patients experienced intraoperative cerebrospinal fluid (CSF) leak. A variety of autologous, synthetic grafts, hemostatic agents, and tissue sealants were placed through the sinonasal cavity for reconstruction. All patients received 24 to 48 hours of a single antibiotic based on patient sensitivity: cefazolin (87%), vancomycin (10%), or clindamycin (3%). Additional antibiotics were subsequently required during the hospital stay in eight (9%) patients for a variety of indications. There were no cases of intracranial infections or meningitis in patients with or without intraoperative CSF leak.
CONCLUSIONS : Despite direct contamination of the intracranial cavity during endoscopic, endonasal skull base surgery, the risk of CNS infections is low. Limited use of a single perioperative antibiotic may be sufficient prophylaxis.
Publication: Laryngoscope 2007 Sep ;117(9)::1528-32.
Publication Date: 2007 Sep
Study Author(s): Brown, Seth M;Anand, Vijay K;Tabaee, Abtin;Schwartz, Theodore H;
Institution: Department of Otorhinolaryngology, Weill Medical College of Cornell University, New York, New York 10021, USA. [email protected]
Shortcut link to this study:
Publication Date: 2007 Sep
Study Author(s): Brown, Seth M;Anand, Vijay K;Tabaee, Abtin;Schwartz, Theodore H;
Institution: Department of Otorhinolaryngology, Weill Medical College of Cornell University, New York, New York 10021, USA. [email protected]
Shortcut link to this study:
OBJECTIVES/HYPOTHESIS : Direct connection between the sinonasal and intracranial cavities and passage of multiple instruments and graft materials through a contaminated field occur routinely during endoscopic pituitary and skull base surgery. Despite the theoretical risk of intracranial contamination with sinonasal flora, the incidence of central nervous system (CNS) infection following such procedures is not well documented, and the ideal antibiotic regimen has yet to be determined.
STUDY DESIGN : Prospective case series of 24 to 48 hours of single-agent perioperative antibiotics in patients undergoing endoscopic skull base surgery.
METHODS : Prospective database of procedures performed between January 2004 and May 2006 was reviewed for antibiotic use and infectious complications.
RESULTS : The diagnoses of the 90 patients in this series included pituitary tumor (62%), craniopharyngioma (9%), encephalocele (9%), and meningioma (8%). Fifty-eight (64%) patients experienced intraoperative cerebrospinal fluid (CSF) leak. A variety of autologous, synthetic grafts, hemostatic agents, and tissue sealants were placed through the sinonasal cavity for reconstruction. All patients received 24 to 48 hours of a single antibiotic based on patient sensitivity: cefazolin (87%), vancomycin (10%), or clindamycin (3%). Additional antibiotics were subsequently required during the hospital stay in eight (9%) patients for a variety of indications. There were no cases of intracranial infections or meningitis in patients with or without intraoperative CSF leak.
CONCLUSIONS : Despite direct contamination of the intracranial cavity during endoscopic, endonasal skull base surgery, the risk of CNS infections is low. Limited use of a single perioperative antibiotic may be sufficient prophylaxis.
STUDY DESIGN : Prospective case series of 24 to 48 hours of single-agent perioperative antibiotics in patients undergoing endoscopic skull base surgery.
METHODS : Prospective database of procedures performed between January 2004 and May 2006 was reviewed for antibiotic use and infectious complications.
RESULTS : The diagnoses of the 90 patients in this series included pituitary tumor (62%), craniopharyngioma (9%), encephalocele (9%), and meningioma (8%). Fifty-eight (64%) patients experienced intraoperative cerebrospinal fluid (CSF) leak. A variety of autologous, synthetic grafts, hemostatic agents, and tissue sealants were placed through the sinonasal cavity for reconstruction. All patients received 24 to 48 hours of a single antibiotic based on patient sensitivity: cefazolin (87%), vancomycin (10%), or clindamycin (3%). Additional antibiotics were subsequently required during the hospital stay in eight (9%) patients for a variety of indications. There were no cases of intracranial infections or meningitis in patients with or without intraoperative CSF leak.
CONCLUSIONS : Despite direct contamination of the intracranial cavity during endoscopic, endonasal skull base surgery, the risk of CNS infections is low. Limited use of a single perioperative antibiotic may be sufficient prophylaxis.
PMID: 17667141
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