Sellar reconstruction: Is it necessary?

被引:29
作者
Sonnenburg, RE
White, D
Ewend, MG
Senior, B
机构
[1] Univ N Carolina, Dept Otolaryngol Head & Neck Surg, Chapel Hill, NC 27599 USA
[2] Univ N Carolina, Dept Neurosurg, Chapel Hill, NC 27599 USA
来源
AMERICAN JOURNAL OF RHINOLOGY | 2003年 / 17卷 / 06期
关键词
D O I
10.1177/194589240301700605
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Background: Sellar reconstruction is practiced routinely during the transsphenoidal approach to pituitary tumor resection. This practice exposes the patient to risks of donor site complications and may interfere with measuring postoperative tumor reduction. We propose that it is not a necessary component of transsphenoidal pituitary surgery in the absence of intraoperative cerebrospinal fluid (CSF) leak. Methods: A retrospective chart review of 45 cases of minimally invasive pituitary surgery were reviewed. Twenty-eight cases were identified with no sellar reconstruction being performed. Age, sex, revision surgery, postoperative CSF leak, days with lumbar drain, meningitis, ophthalmoplegia, visual acuity, loss, postoperative epistaxis, diabetes insipidus, development of empty sella syndrome, and length of stay were investigated in these cases. Results: Twenty-three cases were the primary procedure and five cases were revision surgery. Complication rates were low and compared favorably with those reported in the literature. Five cases of transient diabetes insipidus occurred. There was one postoperative CSF leak that required 4 days with a lumbar drain. No cases of empty; sella syndrome developed. There were no cases of meningitis. The average length of stay was 2.9 days. Conclusion: Sellar reconstruction during transsphenoidal approach to pituitary tumor resection is not required for patients without evidence of an intraoperative CSF leak. This practice exposes the patient to the risks of donor site complications without reducing the rate of postoperative complications.
引用
收藏
页码:343 / 346
页数:4
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