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December 1964

The Management of Postoperative Meningitis

Arch Otolaryngol. 1964;80(6):746-749. doi:10.1001/archotol.1964.00750040762018

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Although it has been generally accepted that any surgical approach to the intracranial structures through the mastoid spaces is accompanied by a high incidence of postoperative meningitis, in this series of 53 cases of acoustic neuromas only three cases have been complicated by meningitis. Up to the present date there has been only one death from this cause (case 10). In this paper we present our concept of the prevention of postsurgical meningitis, and we outline the treatment for this complication when it develops.

Meningitis, complicating surgery for acoustic neuroma, is due most likely to bacteria residing in the patient's nasopharynx. The pyogenic bacteria which cause great concern when found preoperatively on culturing the nose and throat are staphylococci, streptococci, Hemophilus influenzae, meningococci, pneumococci, and Escherichia coli. These bacteria are contaminants as there is no active infection present. In other words, the patient is a carrier of the bacteria. However,

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