The sellar barrier and intraoperative CSF leak in elderly patients.
Adenoma
/ diagnostic imaging
Aged
Cerebrospinal Fluid Leak
/ diagnostic imaging
Female
Humans
Intraoperative Complications
/ diagnostic imaging
Male
Neuroendoscopy
/ adverse effects
Pituitary Gland
/ diagnostic imaging
Pituitary Neoplasms
/ diagnostic imaging
Retrospective Studies
Sella Turcica
/ diagnostic imaging
Cerebrospinal fluid
Neurosurgical procedures
Pituitary Gland
Pituitary neoplasms
Skull base
Journal
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
ISSN: 1532-2653
Titre abrégé: J Clin Neurosci
Pays: Scotland
ID NLM: 9433352
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
08
07
2019
revised:
19
12
2019
accepted:
26
01
2020
pubmed:
20
2
2020
medline:
18
8
2020
entrez:
20
2
2020
Statut:
ppublish
Résumé
Cerebral spinal fluid (CSF) leak is a significant complication in pituitary surgery, increasing both patient morbidity and mortality. In a recent publication, Campero et al. observed worse postoperative prognosis and increased risk of intraoperative CSF leak in patients with reduced sellar barrier thickness. The objective of this study was to analyze the association between sellar barrier thickness and intraoperative CSF leak in older individuals. A retrospective review was conducted of 44 transsphenoidal surgery resections for pituitary adenomas, 24 microscopic and 20 purely endoscopic procedures. Presence of intraoperative CSF fistula was significantly greater in patients with weak sellar barrier (thickness under 1 mm), compared to strong sellar barrier (52.94% vs 3.70% p < 0.0001, respectively). Application of this novel concept may help improve surgical technique selection as well as predict risk of intraoperative CSF leak and need for eventual use of flaps for reconstruction.
Identifiants
pubmed: 32070673
pii: S0967-5868(19)31326-8
doi: 10.1016/j.jocn.2020.01.078
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
48-50Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.