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

Published online by Cambridge University Press:  25 November 2010

C G L Hobbs ,
A Darr  and
W V Carlin
C G L Hobbs*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Western Health, Melbourne, Victoria, Australia
A Darr
Affiliation:
University of Keele School of Medicine, Stoke-on-Trent, UK
W V Carlin
Affiliation:
Department of Otolaryngology - Head and Neck Surgery, University Hospital of North Staffordshire, Stoke-on-Trent, UK
*
Address for correspondence: Mr Chris Hobbs, Department of Otolaryngology – Head and Neck Surgery, Western Hospital, Gordon Street, Footscray, Victoria, Australia3011 Fax: +61 3 8345 6735 E-mail: chris.hobbs@doctors.org.uk
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Abstract

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.

Keywords

Pituitary GlandEndoscopic SurgeryComplicationsCerebrospinal Fluid Leak, Management
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 3 , March 2011 , pp. 311 - 313
Copyright
Copyright © JLO (1984) Limited 2010

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References

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