Management of intraoperative and postoperative cerebrospinal fluid rhinorrhea by neuroendoscopic surgery via endonasal transsphenoidal approach
Zhang Lin
Xie Baoshu
Yao Wenyi
Gao Weizhen
Jia Feng
Wang Yu
Yin Yuhua
Abstract：Objective To explore the management of intraoperative and postoperative cerebrospinal fluid rhinorrhea (CFR) by endoscopic surgery via endonasal transsphenoidal approach.Methods Clinical data of 27 patients with intraoperative and postoperative CFR going endoscopic endonasal transsphenoidal surgery were analyzed retrospectively,including 2 with tubereulum sellae meningioma,1 with chordocarcinoma,1 with optic glioma,1 with metastatic adenoma of the upper slope and 22 with pituitary adenoma.After finding CFR under endoscope,the patients were dealt with by a simple repair or the sellar floor repair by multilayer materials such as autologous adipose tissue,artificial dura mater,biological protein glue and so on according to the ventage size.If the rhinorrhea reoccurred in 3 to 5 d after surgery,the patients were dealt with drug for dehydration and lowering intracranial pressure or continuous lumbar drainage.Results Twenty-one patients with small leakage were dealt with a simple repair in the operation,and 6 patients with bigger leakage were dealt with a multilayer repair.CFR occurred in 3 patients after the operation,and was cured in 2 patients with conservative treatment and in 1 with continuous lumbar drainage for 10 days.During a follow-up period for 5 to 10 months,no patient recurred.Conclusions Surgeon can timely discover CFR under neuroendoscope.The prognosis of CFR can be significantly improved by strict multilayer repair in the operation and effective symptomatic treatment after the operation.
Keywords：cerebrospinal fluid rhinorrheaneuroendoscopessurgical approachtransnasal transsphenoidal
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 385-388 )