The application of nasoseptal “rescue” flap technique in endoscopic transsphenoidal pituitary adenoma resection

To explore the reliability and superiority of nasoseptal “rescue” flap technique in neuroendoscopic transnasal pituitary adenoma resection. Retrospective clinical analysis of 113 cases of endoscopic transsphenoid pituitary adenoma resection with the application of nasoseptal “rescue” flap technology. The reliability and the superiority of the technique were evaluated according to the duration of nasal cavity and sphenoid sinus stage, the incidence of postoperative anosmia, and cerebrospinal rhinorrhea. The duration of nasal and sphenoid sinus stage was 15–30 min, averaging 24 min. There were 27 cases of intro-operative cerebrospinal fluid leakage, including 24 cases of low-flow cerebrospinal fluid leak and 3 cases of high-flow cerebrospinal fluid leak. Twenty-three cases were converted from nasoseptal “rescue” flap to nasal septum flap. There were 17 cases of postoperative olfactory decline or disappearance, 1 case of epistaxis and 1 case of cerebrospinal rhinorrhea. The application of nasoseptal “rescue” flap technique can proceed sellar floor reconstruction when the diaphragma sellae rupture occurs during the operation. There is no obvious increase of the duration of sphenoid sinus and nasal stage and the rate of postoperative olfactory loss. This technique can be used as a conventional technique for endoscopic transsphenoid pituitary adenoma resection.