LUMBAR DRAINAGE AS PROPHYLAXIS FOR CSF FI STULA

Leakage of cerebrospinal fluid may complicate surgical procedures of t he temporal bone and skull base. This presentation details experience utilizing 7 days lumbar drainage in an attempt to prevent the occurren ce of a postoperative CSF fistula. Thirty-nine patients underwent surg ery for various intracranial pathologies and were felt to be at high r isk for the development of postoperative CSF fistulae. None of the pat ients was given prophylactic antibiotics. Ten patients developed clini cal and laboratory findings consistent with early meningitis and were treated with appropriate antibiotics. Three patients eventually develo ped a CSF fistula, with two resolving spontaneously and the third requ iring a second surgical procedure to repair the dura (again using lumb ar drainage postoperatively). Our conclusions suggest that prophylacti c placement of a lumbar catheter in high risk patients increases the l ikelihood of successful dural closure with an acceptable morbidity. Is these patients routine antibiotic coverage is not indicated.