Cerebrospinal Fluid Leak after Transsphenoidal Surgery for Pituitary Adenoma
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- Category: Vol. 84, June 2016
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Cerebrospinal Fluid Leak after Transsphenoidal Surgery for Pituitary Adenoma, HUSSEIN SOFFAR, HELMY ABD EL-HALIM, HAZEM ABD EL-BADIEA, AHMED MOSTAFA and AHMED ELFIKI
Abstract
Objective: To evaluate the incidence, risk factors, preven-tion and management of Cerebrospinal Fluid (CSF) leak after transsphenoidal surgery for pituitary adenoma.
Methods: This study included 40 patients with pituitary adenomas, they were operated upon in neurosurgery department at Cairo University Hospitals from July 2013 to June 2015. With emphasis on CSF leak either intraoperatively or postop-eratively.
Results: The median age of presentation in this study was 33 years. There was 21 females (52.5%) and 19 males (47.5%). intraoperative CSF leak developed in 7 cases (17.5%). 3 cases of them developed early (within 7 days) postoperative CSF rhinorrhea. 1 case developed late (after 30 days) CSF. Rhin-orrhea lumbar drain was effective in treating 2 out of the 3 patients with early CSF leak. 1 case with early CSF leak and the case with late CSF leak needed surgical repair.
Conclusion: When intraoperative CSF leak develops sellar reconstruction with fat graft is important in preventing CSF leak. Lumbar drain decrease the incidence of leak and is an effective way for management.