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A sandwich technique for prevention of cerebrospinal fluid rhinorrhea and reconstruction of the sellar floor after microsurgical transsphenoidal pituitary surgery

Background: Cerebrospinal fluid (CSF) leaks are a well-known complication of transsphenoidal surgery. Several autologous and artificial grafts have been used to close the sellar floor in an attempt to prevent postoperative CSF rhinorrhea. Objective: To evaluate and describe a sandwich technique to...

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Bibliographic Details
Main Authors: Freyschlag, Christian F. (Author) , Goerke, Stephanie Alice (Author) , Obernauer, Jochen (Author) , Kerschbaumer, Johannes (Author) , Thomé, Claudius (Author) , Seiz-Rosenhagen, Marcel (Author)
Format: Article (Journal)
Language:English
Published: 2016
In: Journal of neurological surgery. Part A, Central European neurosurgery
Year: 2016, Volume: 77, Issue: 03, Pages: 229-232
ISSN:2193-6323
DOI:10.1055/s-0035-1547357
Online Access:Verlag, Volltext: https://doi.org/10.1055/s-0035-1547357
Verlag, Volltext: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0035-1547357
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Author Notes:Christian F. Freyschlag, Stephanie Alice Goerke, Jochen Obernauer, Johannes Kerschbaumer, Claudius Thomé, Marcel Seiz
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Summary:Background: Cerebrospinal fluid (CSF) leaks are a well-known complication of transsphenoidal surgery. Several autologous and artificial grafts have been used to close the sellar floor in an attempt to prevent postoperative CSF rhinorrhea. Objective: To evaluate and describe a sandwich technique to close the sellar floor using autologous bone, absorbable gelatin sponge, and coated collagen fleece. Methods: We reviewed 50 consecutive patients between April 2010 and August 2011 who underwent transsphenoidal surgery ending with reconstruction of the sellar floor with a particular sandwich technique. Patients with an intraoperative CSF leak received an additional lumbar drain. Results: There were no cases of CSF rhinorrhea at postoperative follow-up after 6 weeks and no revision surgery. Conclusion: The proposed sandwich technique for closure of the sellar floor to the sphenoid sinus is a suitable alternative to autologous grafts and seems to be effective in preventing CSF rhinorrhea.
Item Description:Gesehen am 06.05.2019
Published online June 19, 2015
Physical Description:Online Resource
ISSN:2193-6323
DOI:10.1055/s-0035-1547357

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