Sellar reconstruction without intrasellar packing after endoscopic surgery of pituitary macroadenomas is better than its reputation
Objectives: Sellar reconstruction with intrasellar packing following endoscopic resection of pituitary macroadenomas remains a subject of clinical and radiological discussion particularly, when an intraoperative cerebrospinal fluid (CSF) leakage is absent. This study was conducted to contribute our...
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| Format: | Article |
| Language: | deu |
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German Medical Science GMS Publishing House
2016-06-01
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| Series: | GMS German Medical Science |
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| Online Access: | http://www.egms.de/static/en/journals/gms/2016-14/000234.shtml |
| _version_ | 1819066510116651008 |
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| author | Ismail, Mostafa Fares, Abd Alla Abdelhak, Balegh D’Haens, Jean Michel, Olaf |
| author_facet | Ismail, Mostafa Fares, Abd Alla Abdelhak, Balegh D’Haens, Jean Michel, Olaf |
| author_sort | Ismail, Mostafa |
| collection | DOAJ |
| description | Objectives: Sellar reconstruction with intrasellar packing following endoscopic resection of pituitary macroadenomas remains a subject of clinical and radiological discussion particularly, when an intraoperative cerebrospinal fluid (CSF) leakage is absent. This study was conducted to contribute our experience with sellar reconstruction after a standard endoscopic surgery of pituitary macroadenomas without intraoperative CSF leakage to the ongoing discussion between techniques with and without intrasellar packing.Methods: A consecutive series of 47 pituitary macroadenomas undergoing excision via a standard endoscopic endonasal transsphenoidal surgery (EETS) without evident intraoperative CSF leakage were retrospectively evaluated over a 10-months mean follow-up period. According to the sellar reconstruction technique, three groups could be identified: Group A – with no intrasellar packing, Group B – with haemostatic materials packing, and Group C – with abdominal fat packing. Postoperative clinical and radiological assessments of the three groups were documented and analyzed for differences in outcome.Results: Postoperative clinical assessment did not differ significantly between the three groups. In group A, postoperative CSF leakage, sphenoid sinusitis and empty sella syndrome were not observed. However, a significant difference in radiological assessment could be identified; the interpretation of sellar contents in postoperative MRI of group A succeeded earlier and more reliably than in other groups with intrasellar packing. Conclusions: There is no difference in the incidence of postoperative CSF leakage and empty sella syndrome among the various reconstructive techniques with and without intrasellar packing, irrespective of size and extension of the pituitary adenoma. Sellar reconstruction without intrasellar packing following a standard EETS is not inferior to other techniques with packing and even shows more radiological advantages, which made it our preferred technique, at least if no intraoperative CSF leakage is evident. |
| first_indexed | 2024-12-21T16:03:30Z |
| format | Article |
| id | doaj.art-37e03e08f972466f9c71d2da8290b9f0 |
| institution | Directory Open Access Journal |
| issn | 1612-3174 |
| language | deu |
| last_indexed | 2024-12-21T16:03:30Z |
| publishDate | 2016-06-01 |
| publisher | German Medical Science GMS Publishing House |
| record_format | Article |
| series | GMS German Medical Science |
| spelling | doaj.art-37e03e08f972466f9c71d2da8290b9f02022-12-21T18:57:56ZdeuGerman Medical Science GMS Publishing HouseGMS German Medical Science1612-31742016-06-0114Doc0710.3205/000234Sellar reconstruction without intrasellar packing after endoscopic surgery of pituitary macroadenomas is better than its reputationIsmail, Mostafa0Fares, Abd Alla1Abdelhak, Balegh2D’Haens, Jean3Michel, Olaf4Department of Otorhinolaryngology, University Hospital Brussels, Vrije Universiteit Brussels, Brussels, BelgiumDepartment of Radiology, University Hospital Brussels, Vrije Universiteit Brussels, Brussels, BelgiumDepartment of Otorhinolaryngology, Minia University Hospital, Minia University, Minya, EgyptDepartment of Neurosurgery, University Hospital Brussels, Vrije Universiteit Brussels, Brussels, BelgiumDepartment of Otorhinolaryngology, University Hospital Brussels, Vrije Universiteit Brussels, Brussels, BelgiumObjectives: Sellar reconstruction with intrasellar packing following endoscopic resection of pituitary macroadenomas remains a subject of clinical and radiological discussion particularly, when an intraoperative cerebrospinal fluid (CSF) leakage is absent. This study was conducted to contribute our experience with sellar reconstruction after a standard endoscopic surgery of pituitary macroadenomas without intraoperative CSF leakage to the ongoing discussion between techniques with and without intrasellar packing.Methods: A consecutive series of 47 pituitary macroadenomas undergoing excision via a standard endoscopic endonasal transsphenoidal surgery (EETS) without evident intraoperative CSF leakage were retrospectively evaluated over a 10-months mean follow-up period. According to the sellar reconstruction technique, three groups could be identified: Group A – with no intrasellar packing, Group B – with haemostatic materials packing, and Group C – with abdominal fat packing. Postoperative clinical and radiological assessments of the three groups were documented and analyzed for differences in outcome.Results: Postoperative clinical assessment did not differ significantly between the three groups. In group A, postoperative CSF leakage, sphenoid sinusitis and empty sella syndrome were not observed. However, a significant difference in radiological assessment could be identified; the interpretation of sellar contents in postoperative MRI of group A succeeded earlier and more reliably than in other groups with intrasellar packing. Conclusions: There is no difference in the incidence of postoperative CSF leakage and empty sella syndrome among the various reconstructive techniques with and without intrasellar packing, irrespective of size and extension of the pituitary adenoma. Sellar reconstruction without intrasellar packing following a standard EETS is not inferior to other techniques with packing and even shows more radiological advantages, which made it our preferred technique, at least if no intraoperative CSF leakage is evident.http://www.egms.de/static/en/journals/gms/2016-14/000234.shtmltranssphenoidal surgerypituitary macroadenomassellar reconstructionintrasellar packingCSF leakage |
| spellingShingle | Ismail, Mostafa Fares, Abd Alla Abdelhak, Balegh D’Haens, Jean Michel, Olaf Sellar reconstruction without intrasellar packing after endoscopic surgery of pituitary macroadenomas is better than its reputation GMS German Medical Science transsphenoidal surgery pituitary macroadenomas sellar reconstruction intrasellar packing CSF leakage |
| title | Sellar reconstruction without intrasellar packing after endoscopic surgery of pituitary macroadenomas is better than its reputation |
| title_full | Sellar reconstruction without intrasellar packing after endoscopic surgery of pituitary macroadenomas is better than its reputation |
| title_fullStr | Sellar reconstruction without intrasellar packing after endoscopic surgery of pituitary macroadenomas is better than its reputation |
| title_full_unstemmed | Sellar reconstruction without intrasellar packing after endoscopic surgery of pituitary macroadenomas is better than its reputation |
| title_short | Sellar reconstruction without intrasellar packing after endoscopic surgery of pituitary macroadenomas is better than its reputation |
| title_sort | sellar reconstruction without intrasellar packing after endoscopic surgery of pituitary macroadenomas is better than its reputation |
| topic | transsphenoidal surgery pituitary macroadenomas sellar reconstruction intrasellar packing CSF leakage |
| url | http://www.egms.de/static/en/journals/gms/2016-14/000234.shtml |
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