Evaluating the Effect of Prophylactic Topical Antibiotic Irrigation on Nasal Packing Colonization Following Endoscopic Skull Base Surgery
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Intracranial Pathology
- Sponsor
- Carl Snyderman
- Locations
- 1
- Primary Endpoint
- Which bacteria colonize nasal packing following endoscopic skull base surgery
- Status
- Withdrawn
- Last Updated
- 3 years ago
Overview
Brief Summary
This is an interventional study that will examine the effect of prophylactic topical antibiotics on nasal packing colonization following endoscopic skull base surgery.
Detailed Description
Following endoscopic skull base surgery (ESBS), nasal packing is used to control bleeding and to support reconstruction but can be a source for possibly infectious colonization. Antibiotic use and selection in ESBS varies largely and topical antibiotics are not routinely employed despite favorable qualities (i.e. direct delivery of high antibiotic concentrations with low adverse systemic effects). The effect of prophylactic topical antibiotics on nasal packing colonization is currently understudied. A larger study is needed to test the validity of the conclusion. Employing a larger sample size undergoing ESBS (which does not directly act on the nasal cavity), the investigators hope to amend the lack of literature evaluating the effect of prophylactic topical antibiotics on nasal packing post-ESBS. THe investigators hope to contribute to the determination of an ideal antibiotic regimen following ESBS, which may be especially beneficial for immunocompromised patients or patients at risk of post-surgery infections such as meningitis. Furthermore, the effect of ESBS on the nasal flora is largely understudied, with limited literature only reporting on the nasal flora following endoscopic sinus surgery (ESS). The investigators hope to also amend the lack of literature exploring the effects of ESBS on the nasal flora, especially long-term effects that may be examined in patients undergoing revision surgery.
Investigators
Carl Snyderman
Professor
University of Pittsburgh
Eligibility Criteria
Inclusion Criteria
- •Patients undergoing primary or revision endoscopic skull base surgery
- •Sellar or Intracranial pathology
Exclusion Criteria
- •Patients with sinonasal malignancy
- •Prior radiation therapy
- •Concurrent sinusitis and/or nasal polyposis
Outcomes
Primary Outcomes
Which bacteria colonize nasal packing following endoscopic skull base surgery
Time Frame: 1 year
The bacteria making up the colonization of nasal packing post-endoscopic skull base surgery will be identified using culture analysis.
Can prophylactic topical antibiotics alter the colonization of nasal packing following endoscopic skull base surgery
Time Frame: 1 year
The effect of prophylactic topical antibiotics on nasal packing colonization post-endoscopic skull base surgery will be measured using culture analysis. Colonization will be described as type(s) of bacteria.
Can prophylactic topical antibiotics alter the bacterial load of nasal packing following endoscopic skull base surgery
Time Frame: 1 year
The effect of prophylactic topical antibiotics on the bacterial load of nasal packings post-endoscopic skull base surgery will be measured using culture analysis. Bacterial load will be measured in colony forming units (CFUs).
Secondary Outcomes
- Does endoscopic skull base surgery later the nasal flora(1 year)