Rhinorrhée cérébrospinale après chirurgie hypophysaire endoscopique trans-sphénoïdale : réflexions après 337 patients [Cerebrospinal fluid rhinorrhea following endocopic trans-sphenoidal pituitary surgery: Experience from 337 patients].
Détails
ID Serval
serval:BIB_66E4E0015E80
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Rhinorrhée cérébrospinale après chirurgie hypophysaire endoscopique trans-sphénoïdale : réflexions après 337 patients [Cerebrospinal fluid rhinorrhea following endocopic trans-sphenoidal pituitary surgery: Experience from 337 patients].
Périodique
Neuro-chirurgie
ISSN
0028-3770 (Print)
ISSN-L
0028-3770
Statut éditorial
Publié
Date de publication
2012
Peer-reviewed
Oui
Volume
58
Numéro
4
Pages
241-245
Langue
français
Résumé
INTRODUCTION: Cerebrospinal fluid (CSF) leak is a frequent complication after trans-sphenoidal pituitary surgery. We try to determine the incidence, risk factors, diagnostic procedures, and management of CSF leaks following trans-sphenoidal pituitary macroadenoma surgery.
METHODS: A retrospective analysis of 337 patients data.
RESULTS: Postoperative CSF leaks occurred in 11 patients (3,1%). Ten patients had to be reoperated. Three patients had meningitis. Intraoperative CSF leak is the only significant predictive factor of postoperative CSF leak. Revision surgery, wide opening of the sella turcica and insufficient reconstruction of the sellar floor also seem to play a role (for six cases of postoperative CSF leak, the closure material had been excluded).
CONCLUSION: Prevention of the postoperative CSF leak needs screening of intra-operative CSF leak. The strength of the sellar floor is essential in order to avoid the ejection of the closure material, related to the intracranial pression.
METHODS: A retrospective analysis of 337 patients data.
RESULTS: Postoperative CSF leaks occurred in 11 patients (3,1%). Ten patients had to be reoperated. Three patients had meningitis. Intraoperative CSF leak is the only significant predictive factor of postoperative CSF leak. Revision surgery, wide opening of the sella turcica and insufficient reconstruction of the sellar floor also seem to play a role (for six cases of postoperative CSF leak, the closure material had been excluded).
CONCLUSION: Prevention of the postoperative CSF leak needs screening of intra-operative CSF leak. The strength of the sellar floor is essential in order to avoid the ejection of the closure material, related to the intracranial pression.
Mots-clé
Cerebrospinal Fluid Rhinorrhea/etiology, Cerebrospinal Fluid Rhinorrhea/prevention & control, Endoscopy/methods, Humans, Intraoperative Period, Meningitis/complications, Pituitary Gland/surgery, Pituitary Neoplasms/surgery, Postoperative Complications/etiology, Postoperative Complications/prevention & control, Predictive Value of Tests, Recurrence, Retrospective Studies, Sella Turcica/surgery, Sphenoid Bone/surgery, Tomography, X-Ray Computed
Pubmed
Création de la notice
07/04/2016 15:48
Dernière modification de la notice
20/08/2019 15:22
Données d'usage
