A new technique for dural suturing with fascia graft for cerebrospinal fluid leakage in transsphenoidal surgery
Abstract
One of the most common postoperative complications of surgery using a transsphenoidal approach is cerebrospinal fluid (CSF) leakage, which typically results from inadequate repair of a CSF fistula created at the time of the initial operation. Most techniques use autologous tissue grafts of fat, muscle, or fascia lata, with or without the use of postoperative lumbar CSF drainage; however, patients demonstrate a relatively high incidence of CSF rhinorrhea, especially after extended procedures. We have developed a new technique of dural suturing with fascia graft using special suture-tying microinstruments. Twenty-one consecutive patients with suprasellar tumors underwent dural suturing with fascia graft via new suture-tying microinstruments between January 2004 and December 2007. The 21 patients were retrospectively divided into 2 groups according to the transsphenoidal technique used. Group 1 consisted of 16 patients whose large dural defects were closed with a fascia graft suture for CSF leakage during or after an extended transsphenoidal approach. Group 2 consisted of 5 patients whose dural defects were closed with a fascia graft suture for postoperative CSF rhinorrhea after a conventional transsphenoidal approach. None of the...Continue Reading
References
Extended endoscopic endonasal transsphenoidal approach for the removal of suprasellar tumors: Part 2
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