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].

Details

Serval ID
serval:BIB_66E4E0015E80
Type
Article: article from journal or magazin.
Collection
Publications
Title
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].
Journal
Neuro-chirurgie
Author(s)
Duntze J., Litré C.F., Graillon T., Maduri R., Pech-gourg G., Rakotozanany P., Gras R., Dufour H.
ISSN
0028-3770 (Print)
ISSN-L
0028-3770
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
58
Number
4
Pages
241-245
Language
french
Abstract
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.
Keywords
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
Create date
07/04/2016 14:48
Last modification date
20/08/2019 14:22
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