OBJECTIVE: The purpose of this study was to describe the endoscopic combined "transseptal/transnasal" approach with a pedicled nasoseptal flap for pituitary adenoma and skull base reconstruction, especially with respect to cerebrospinal fluid (CSF) fistula. METHOD: Ninety-one consecutive patients with pituitary adenomas were retrospectively reviewed. All patients underwent the endoscopic combined "transseptal/transnasal" approach by the single team including the otorhinolaryngologists and neurosurgeons. Postoperative complications related to the flap were analyzed. RESULTS: Intra- and postoperative CSF fistulae were observed in 36 (40%) and 4 (4.4%) patients, respectively. Among the 4 patients, lumbar drainage and bed rest healed the CSF fistula in 3 patients and reoperation for revision was necessary in one patient. Other flap-related complications included nasal bleeding in 3 patients (3.3%). CONCLUSION: The endoscopic combined "transseptal/transnasal" approach is most suitable for a two-surgeon technique and a pedicled nasoseptal flap is a reliable technique for preventing postoperative CSF fistula in pituitary surgery.
OBJECTIVE: The purpose of this study was to describe the endoscopic combined "transseptal/transnasal" approach with a pedicled nasoseptal flap for pituitary adenoma and skull base reconstruction, especially with respect to cerebrospinal fluid (CSF) fistula. METHOD: Ninety-one consecutive patients with pituitary adenomas were retrospectively reviewed. All patients underwent the endoscopic combined "transseptal/transnasal" approach by the single team including the otorhinolaryngologists and neurosurgeons. Postoperative complications related to the flap were analyzed. RESULTS: Intra- and postoperative CSF fistulae were observed in 36 (40%) and 4 (4.4%) patients, respectively. Among the 4 patients, lumbar drainage and bed rest healed the CSF fistula in 3 patients and reoperation for revision was necessary in one patient. Other flap-related complications included nasal bleeding in 3 patients (3.3%). CONCLUSION: The endoscopic combined "transseptal/transnasal" approach is most suitable for a two-surgeon technique and a pedicled nasoseptal flap is a reliable technique for preventing postoperative CSF fistula in pituitary surgery.
Authors: João Mangussi-Gomes; Leonardo L Balsalobre; Marcos Q T Gomes; Eduardo A S Vellutini; Aldo C Stamm Journal: J Neurol Surg B Skull Base Date: 2018-01-19
Authors: Christina Dorismond; Griffin D Santarelli; Brian D Thorp; Adam J Kimple; Charles S Ebert; Adam M Zanation Journal: J Neurol Surg B Skull Base Date: 2020-08-07
Authors: James Barger; Matthew Siow; Michael Kader; Katherine Phillips; Girish Fatterpekar; David Kleinberg; David Zagzag; Chandranath Sen; John G Golfinos; Richard Lebowitz; Dimitris G Placantonakis Journal: Surg Neurol Int Date: 2018-02-14