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  • Post-Operative Infection in Vestibular Schwannoma Surgery

    Final Number:
    1443

    Authors:
    Thomas Michael O'Lynnger MD; Saniya S. Godil MD; Philip Ryan Brinson BS; Muhammad Z. Chauhan; Kyle D. Weaver MD; Reid C. Thompson MD; Lola Blackwell Chambless MD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Post-operative infection is an important cause of morbidity in patients undergoing surgery for vestibular schwannoma. We sought to determine what patient characteristics and surgical factors were associated with post-operative infection.

    Methods: We conducted a retrospective analysis of 130 patients who underwent a translabyrinthine or retrosigmoid approach for vestibular schwannoma at Vanderbilt University Medical Center from January 2004 to April 2013, collecting data on patient characteristics and perioperative variables. Infection was defined as evidence of meningitis or wound infection. Cerebrospinal fluid leak was defined as wound leakage, rhinorrhea, or pseudomeningocele. The chi-square test and simple logistic regression were used for analysis with significance set at 0.05.

    Results: There was no significant relationship between infection and age greater than 50 years, sex, hypertension, coronary artery disease, chronic obstructive pulmonary disease, or diabetes (Table 1). Additionally, the modifiable risk factors of obesity and smoking were not significantly associated with the odds of infection post-operatively. Perioperative factors including approach, procedure length, and length of stay were also not significantly associated with infection. The presence of cerebrospinal fluid leak was significantly associated with infection (p<0.001).

    Conclusions: None of the patient comorbidities we measured were significantly associated with the odds of infection. This is important for counseling regarding surgical treatment of vestibular schwannoma as several common comorbid conditions were not significantly associated with post-operative infection. Interestingly, length of stay and procedure length were not associated with increased odds of infection in our series. Cerebrospinal fluid leak is highly associated with infection, indicating the importance of proper surgical technique and closure.

    Patient Care: By analyzing the relationship between patient characteristics and post-operative risk of infection, we will be better able to counsel patients regarding risks and benefits of surgery for vestibular schwannoma on an individual basis.

    Learning Objectives: By the conclusion of this session, participants should be able to describe the association between patient characteristics and post-operative infection in vestibular schwannoma surgery.

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