Analysis Of Risk Factors For Intracranial Infection Associated With Extended Endoscopic Endonasal Approach

Objective:To study and analysis the risk factors of intracranial infection associated with extended transnasal endoscopic approach(EEA),so as to provide reference for the prevention and treatment of intracranial infection..Methods:The clinical data of 408 patients who underwent endoscopic extended approach surgery in the Department of Neurosurgery of the First Affiliated Hospital of Nanchang University from January 2018 to July 2021 were retrospectively analyzed.According to the occurrence of intracranial infection,the patients were divided into infection group and non infection group.The detailed clinical data of the two groups were collected.Univariate and multivariate logistic regression were used to analyze the risk factors of intracranial infection associated with EEA surgery.Results:Among 408 surgical patients,22(5.39%)were intracranial infection group and386(94.61%)were non infection group.The results of univariate analysis showed that age >45 years old,maximum tumor diameter >3cm,intraoperative cerebrospinal fluid leakage grade >grade 2,intraoperative three ventricular floor opening,intraoperative hypothalamic injury grade >grade 2,intraoperative pituitary stalk injury grade >grade 1,skull base bone reconstruction and postoperative cerebrospinal fluid leakage were the influencing factors of postoperative intracranial infection.The results of multivariate logistic regression analysis showed that,The largest tumor diameter and postoperative cerebrospinal fluid leakage are independent risk factors for Eeea related intracranial infection.Skull base reconstruction with in situ bone flap or nasal septal bone flap combined with vascularized nasal septal flap(vp-nsf)is an independent protective factor for EEA related intracranial infection.Conclusion:It is necessary to formulate different strategies for cerebrospinal fluid leakage repair and skull base reconstruction according to the location and diameter of the tumor during EEA,and try to avoid long-term lumbar puncture and drainage after EEA.These measures can effectively prevent the occurrence of intracranial infection associated with EEA surgery.