Risk factors of early cerebrospinal fluid rhinorrhea in patients with pituitary adenomas after endoscopic endonasal transsphenoidal surgery
ZHOU Meng
LIU Yan-ting
TIAN Chun-lei
LEI Zhi-heng
LUO Ran
Abstract：Objective To investigate the risk factors of early(1 week)cerebrospinal fluid rhinorrhea(CFR)in patients with pituitary adenomas after endoscopic endonasal transsphenoidal surgery(EETS).Methods The clinical data of 246 patients with pituitary adenomas treated by EETS from January 2017 to January 2022 were retrospectively analyzed.CFR was diagnosed with glucose＞1.7 mmol/L in the leaking fluid within 1 week after surgery.Results Of these 246 patients,30 patients(12.2％)suffered from early CFR after operation.Multivariate logistic regression analysis showed that the texture of tumor(OR=4.013;95％ CI 1.289～12.497;P=0.017),large upper and lower diameter of tumor(OR=1.149;95％ CI 1.039～1.271;P=0.007),and intraoperative cerebrospinal fluid leakage(ICFL)(OR=26.425;95％ CI 7.034～99.278;P=0.001)were independent risk factors for early CFR,while the use of vascularized nasal septum mucosal flap to repair skull base(OR=0.026;95％ CI 0.003～0.261;P=0.002)was a protective factor for early CFR.Compared with patients with grade 1 ICFL(47.2％,17/36),the rates of early CFR in grade 0 patients(5.3％,10/188),grade 2 patients(16.7％,2/12),and grade 3 patients(10.0％,1/10)significantly decreased(P＜0.05).There was no significant difference in the rates of early CFR among grade 0,grade 2 and grade 3 patients(P＞0.05).Conclusions For patients with pituitary adenomas undergoing EETS,the risk of early CFR is increased in patients with tough texture tumors,larger diameter of the upper and lower part of the tumors and the ICFL,while the use of vascular pedicled nasal septum mucosal flap to repair the skull base can reduce the incidence of early CFR.
Keywords：Pituitary adenomasCerebrospinal fluid rhinorrheaEndoscopic endonasal transsphenoidal surgeryRisk factors
Publication Date：2023-12-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 701-704 )