Strategy of sellar floor reconstruction of resection of pituitary adenoma via neuroendoscopic transsphenoidal approach

Abstract

Objective To investigate the methods and effect of sellar floor reconstruction after resection of pituitary adenoma via neuroendoscopic transsphenoidal approach. Methods From August 2006 and August 2014, the clinical data of 115 patients with pituitary adenoma admitted to the Department of Neurosurgery, Inner Mongolia People’s Hospital were analyzed retrospectively. All patients underwent resection of pituitary adenoma via single nostril neuroendoscopic transsphenoidal approach. Ninety-seven patients with no obvious cerebrospinal fluid leakage during the operations were treated with artificial dural reconstruction of the sellar floor dura (simple repair). Subcutaneous fat, muscle, fascia, and artificial dura layer repair were used to reconstruct the sellar floor dura in 18 patients with cerebrospinal fluid leakage (complex repair). The follow-up time ranged from 6 to 36 months (mean, 25.5 months). Results The pituitary adenomas of 97 patients (84.3%) were resected completely and 18 (15.7%) were resected subtotally. A total of 86 patients completed follow-up and 29 lost to follow up. None of the patients experienced cerebrospinal fluid leakage within the follow-up period. Conclusions For patients whose pituitary adenomas were resected via single nostril neuroendoscopic transsphenoidal approach, taking the corresponding sellar floor reconstruction strategy can effectively prevent postoperative cerebrospinal fluid leakage and reduce postoperative complications according to whether occurring cerebrospinal fluid leakage or not during the operations. Key words: Pituitary neoplasms; Neuroendoscopy; Cerebrospinal fluid rhinorrhea; Neurosurgical procedures; Sellar floor reconstruction