| Autor: |
Pailler JI; LINT, Facultad de Medicina, Universidad Nacional de Tucumán, San Miguel de Tucumán 4000, Argentina., Villalonga JF; LINT, Facultad de Medicina, Universidad Nacional de Tucumán, San Miguel de Tucumán 4000, Argentina., Ries-Centeno T; Departamento de Neurocirugía, FLENI, Buenos Aires 1625, Argentina., Saenz A; LINT, Facultad de Medicina, Universidad Nacional de Tucumán, San Miguel de Tucumán 4000, Argentina., Baldoncini M; LINT, Facultad de Medicina, Universidad Nacional de Tucumán, San Miguel de Tucumán 4000, Argentina., Pipolo DO; LINT, Facultad de Medicina, Universidad Nacional de Tucumán, San Miguel de Tucumán 4000, Argentina., Cárdenas Ruiz-Valdepeñas E; Hospital Virgen del Rocío, 41013 Sevilla, Spain., Kaen A; Hospital Virgen del Rocío, 41013 Sevilla, Spain., Hirtler L; Endoscopic Laboratory of Anatomy Center, Medical University of Vienna, 1090 Vienna, Austria., Roytowski D; Department of Neurosurgery, University of Cape Town, Cape Town 7701, South Africa., Solari D; Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Universita' degli Studi di Napoli Federico II, 80131 Naples, Italy., Cervio A; Departamento de Neurocirugía, FLENI, Buenos Aires 1625, Argentina., Campero A; LINT, Facultad de Medicina, Universidad Nacional de Tucumán, San Miguel de Tucumán 4000, Argentina. |
| Abstrakt: |
There is evidence of association between sellar barrier thickness and intraoperative cerebrospinal fluid (CSF) leakage, impacting the postoperative prognosis of the patients. The aim of this study is to analyze the clinical applicability of the sellar barrier concept in a series of operated patients with pituitary apoplexy (PA). A retrospective study was conducted including 47 patients diagnosed with PA who underwent surgical treatment through a transsphenoidal approach. Brain magnetic resonance imaging (MRI) of the patients were evaluated and classified utilizing the following criteria: strong barrier (greater than 1 mm), weak barrier (less than 1 mm), and mixed barrier (less than 1 mm in one area and greater than 1 mm in another). The association between sellar barrier types and CSF leakage was analyzed, both pre- and intraoperatively. The preoperative MRI classification identified 10 (21.28%) patients presenting a weak sellar barrier, 20 patients (42.55%) with a mixed sellar barrier, and 17 patients (36.17%) exhibiting a strong sellar barrier. Preoperative weak and strong sellar barrier subtypes were associated with weak ( p ≤ 0.001) and strong ( p = 0.009) intraoperative sellar barriers, respectively. Strong intraoperative sellar barrier subtypes reduced the odds of CSF leakage by 86% ( p = 0.01). A correlation between preoperative imaging and intraoperative findings in the setting of pituitary apoplexy has been observed. |
