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1 results

  • Management of intra-operative cerebrospinal fluid leak following endoscopic trans-sphenoidal pituitary surgery

  • C G L Hobbs, A Darr, W V Carlin
  • Journal:
    The Journal of Laryngology & Otology / Volume 125 / Issue 3 / March 2011
    Published online by Cambridge University Press:
    25 November 2010, pp. 311-313
    Print publication:
    March 2011
  • Objective:

    Cerebrospinal fluid leakage is the most common complication of endoscopic trans-sphenoidal pituitary surgery. However, there is no uniformly accepted way of managing this complication when it occurs intra-operatively. This paper describes a quick, simple technique, involving layered fibrin glue and gelatin sponge, which does not compromise post-operative patient follow up.

    Method:

    Retrospective review of all endoscopic pituitary surgery cases conducted at a single institution since the introduction of this technique in 2002.

    Results:

    A total of 120 endoscopic pituitary operations were performed (96 primary procedures and 24 revisions). All intra-operative cerebrospinal fluid leaks were managed using the described method, with a failure rate of 3.6 per cent. The overall post-operative leakage rate was 1.7 per cent.

    Conclusion:

    This simple, conservative technique avoids the need for further dissection and the use of non-absorbable foreign material, and has a low incidence of post-operative cerebrospinal fluid leakage.