Abstract
Background: The nasoseptal flap, commonly used in endoscopic transsphenoidal surgical, is typically held in position for several days post-operatively by a nasal Foley catheter balloon. The purpose of this study is to describe our experience with an alternative technique to buttress the nasoseptal flap that renders the use of a Foley catheter unnecessary. Methods: A review of our Halifax Neuropituitary Program’s database identified patients who underwent endoscopic transsphenoidal surgery for a pituitary macroadenoma with nasoseptal flap, secured with small rolls of GelfoamTM rather than a nasal Foley catheter. Minimum follow-up clinical and MRI assessments: 3 months. Results: 69 patients (mean follow-up: 22 months) met the inclusion criteria: 53 non-functioning and 16 functioning pituitary adenomas. 36 patients had an intraoperative CSF leak: 29 high flow and 7 low flow leaks. 35 patients were repaired by a fat +/- fascia graft. One patient had a post-operative CSF leak repaired by subsequent surgery without the use of a Foley catheter. Conclusions: In our experience, 1 of the 69 (1.4%) patients required post-operative CSF leak repair, well within the incidence of 1 to 3% reported in the literature. Securing the nasoseptal flap can be achieved without the use of a nasal Foley catheter.
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Schedule a callMore From: Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
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