Repair and prevention of cerebrospinal fluid leakage in transsphenoidal surgery: a sphenoid sinus mucosa technique

Neurosurgical Review
Kosaku AmanoYoshikazu Okada

Abstract

Cerebrospinal fluid (CSF) leakage is a common but sometimes serious complication after transsphenoidal surgery (TSS). To avoid this postsurgical complication, we usually repair the CSF leaking area using an autologous material, such as fat, fascia, or muscle graft and sometimes nasonasal septal flap. In this report, we propose a technique using a novel autologous material, sphenoid sinus mucosa (SSM), to repair intraoperative CSF leakage or prevent it postoperatively. On 26 February 2007, we introduced the technique of using SSM to repair or prevent CSF leakage in TSS. Until 30th of June 2014, we performed 500 TSSs for patients with pituitary or parasellar lesions. They were 195 men and 305 women with a mean age of 48.5 years (range, 5-85 years). We used SSM for patching or suturing the arachnoid laceration or dural defect, in lieu of fat or fascia harvested from abdomen or thigh, or made pedicle flap of SSM instead of nasonasal septal flap to cover the sellar floor. Comparing the previous 539 cases not using these techniques before 26 February 2007, intraoperative CSF leakage increased from 49 to 69.4% (p < 0.0001) due to more aggressive surgical technique, mainly related to more extensive approaches and lesion removals, but t...Continue Reading

References

Mar 1, 1995·Journal of Neurosurgery·P K NarotamK D Bhoola
Jan 1, 1993·British Journal of Neurosurgery·P K NarotamD Raidoo
Jan 22, 2002·The Laryngoscope·T NakagawaK Tomiyama
Aug 21, 2002·Journal of Neurosurgery·Paolo CappabiancaEnrico de Divitiis
Nov 26, 2002·Neurosurgery·Paolo CappabiancaEnrico De Divitiis
Jun 2, 2005·Journal of Neurosurgery·Joshua R DusickNeil A Martin
May 20, 2006·Neurosurgical Focus·Takeshi ShimamuraRaj K Puri
Oct 17, 2007·Journal of Neurosurgery·Luigi Maria CavalloPaolo Cappabianca
Jun 24, 2008·Acta Oto-laryngologica·Tae-Mi YoonShin Jung
Aug 30, 2008·Neurosurgery·Paul A GardnerDaniel M Prevedello
Jan 27, 2009·Neurologia Medico-chirurgica·Shigetoshi YanoJun-ichi Kuratsu
Feb 26, 2009·Skull Base : Official Journal of North American Skull Base Society ... [et Al.]·Omar A El-BanhawyMohamed M El-Sharnoby
Mar 18, 2009·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Patra CharalampakiAxel Perneczky
Jun 6, 2009·Acta neurochirurgica·Hiroshi NishiokaJo Haraoka
Jul 2, 2010·Skull Base : Official Journal of North American Skull Base Society ... [et Al.]·Harshita PantAmin B Kassam
Oct 5, 2010·Neurologia Medico-chirurgica·Naokatsu SaekiYoshitaka Okamoto
Dec 21, 2010·Journal of Neurosurgery·Amin B KassamMichael B Horowitz
Jul 10, 2012·American Journal of Otolaryngology·Reza VaezeafsharJustin H Turner

❮ Previous
Next ❯

Citations

Nov 30, 2018·Journal of Neurosurgery·Takayuki IshikawaToshihiko Wakabayashi
Jul 23, 2019·International Forum of Allergy & Rhinology·Eric W WangCarl H Snyderman
Jul 10, 2018·Neurosurgical Review·Toshihiro OgiwaraKazuhiro Hongo
Jan 25, 2017·Spinal Cord Series and Cases·Chikara UshikuAkio Minami
Jul 12, 2021·European Annals of Otorhinolaryngology, Head and Neck Diseases·P-F ChenY-H Lin

❮ Previous
Next ❯

Related Concepts

Related Feeds

CSF & Lymphatic System

This feed focuses on Cerebral Spinal Fluid (CSF) and the lymphatic system. Discover the latest papers using imaging techniques to track CSF outflow into the lymphatic system in animal models.