Effect of fat tamponade on cerebrospinal fluid leakage during endoscopic transsphenoidal pituitary adenoma resection
DONG Ce
YUE Xiongfei
ZHU Lin
Abstract：Objective To investigate the role of fat tamponade in sellar floor reconstruction during endoscopic transsphenoidal pituitary adenoma resection.Methods From June 2016 to June 2021,clinical data of 96 patients with cerebrospinal fluid(CSF)leakage during endoscopic transsphenoidal pituitary adenoma resection admitted to the Department of Neurosurgery of Hebei General Hospital were collected for historical control study.According to the time of surgery and surgical procedures,48 patients surgically treated after 2019 were included in the observation group,and they were managed by sellar floor reconstruction using fat tamponade,gelatin sponge,artificial dura mater suturing and nasoseptal flap technique.In the observation group,there were 37 and 11 cases of type 1 and type 2 CSF leakage,respectively.Another 48 patients surgically treated before 2019 were included in the control group,and they were managed by sellar floor reconstruction using gelatin sponge,artificial dura mater suturing and nasoseptal flap technique.In the control group,there were 41 and 7 cases of type 1 and type 2 CSF leakage,respectively.The surgery effective rate was compared between groups based on the incidence of CSF leakage postoperatively and during the follow-up period for 15-26 months.Results The overall incidence of CSF leakage in the observation group was 4.1％(2/48),and the incidence of continuous type 1 and 2 CSF leakage postoperatively was 2.7％(1/37)and 9.1％(1/11),respectively.The overall incidence of CSF leakage in the control group was 16.7％(8/48),and the incidence of continuous type 1 and 2 CSF leakage postoperatively was 7.3％(3/41)and 71.4％(5/7),respectively.There was a significant difference in the overall incidence of CSF leakage between groups(P＜0.05).Conclusion Fat tamponade plays an important role in sellar floor reconstruction,especially for patients with intraoperative type 2-3 CSF leakage.It effectively lowers the incidence of postoperative CSF leakage.However,the efficacy of fat tamponade during sellar floor reconstruction in patients with intraoperative type 1 CSF leakage needs to be further analyzed.
Keywords：neuroendoscopypituitary adenomasellar floor reconstructioncerebrospinal fluid leakage
Publication Date：2024-10-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 3088-3091 )