Incidence and Risk Factors of Postoperative Meningitis Following Endoscopic Endonasal Transsphenoidal Surgery: A Study in Thailand.

Objectives: Postoperative meningitis following endoscopic endonasal transsphenoidal surgery (TSS) is a critical outcome metric. Meningitis is one of the most severe complications in neurosurgery, particularly with transsphenoidal procedures, due to the potential for bacterial contamination from the nasal or sinus cavities. Identifying the risk factors associated with postoperative meningitis is crucial for preventing and minimizing this risk in future surgeries. Materials and Methods: The study reviewed admission forms, operative notes, and the occurrence of various complications in patients who underwent the TSS approach between 2010 and 2024, focusing on variations in health care access and surgical practices. Statistical Analysis: Descriptive statistics will summarize demographic, surgical, and clinical characteristics. Univariate analysis: risk factors for meningitis could be evaluated through chi-square tests for categorical variables (e.g., presence of a cerebrospinal fluid [CSF] leak) and Results: A total of 237 patients who underwent TSS between 2010 and 2024 were included in the final analysis. The overall incidence of postoperative meningitis was 23%. Intra- and postoperative CSF leakage, diabetes mellitus, obesity, and previous sinus or nasal infection were found to be a significant factor associated with postoperative meningitis. Conclusion: Understanding the risk factors for meningitis following TSS is crucial for improving patient outcomes. While preoperative nares cleaning with normal saline may reduce nasal congestion, our findings indicate that it does not significantly affect the rate of postoperative meningitis compared with Hibitane-only cleaning.