Rhinorrhée cérébrospinale après chirurgie hypophysaire endoscopique trans-sphénoïdale : réflexions après 337 patients

Autor:	R. Gras, P. Rakotozanany, C.F. Litré, Thomas Graillon, J. Duntze, R. Maduri, G. Pech-Gourg, H. Dufour
Rok vydání:	2012
Předmět:	Leak medicine.medical_specialty rhinorrhea medicine.diagnostic_test business.industry medicine.disease Surgery Endoscopy Sella turcica medicine.anatomical_structure Cerebrospinal fluid Pituitary adenoma Medicine Neurology (clinical) medicine.symptom business Complication Meningitis
Zdroj:	Neurochirurgie. 58:241-245
ISSN:	0028-3770
DOI:	10.1016/j.neuchi.2012.02.005
Popis:	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.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::e13db8082db558e1f16a78c4e3f6dcb6 https://doi.org/10.1016/j.neuchi.2012.02.005 Zobrazit plný text záznamu Full Text from ScienceDirect