Single-Center Experience with Lumbar Drain Use for Cerebrospinal Fluid Leak following Transsphenoidal Surgery

The detailed surgical procedure of the transsphenoidal surgery for pituitary abscess has scarcely been described previously because it is a very rare clinical entity. The authors reported two cases of primary pituitary abscess. In case 1, the anterior wall of the sella turcica was reconstructed with the vomer bone after irrigating the abscess cavity, but the sella was not packed by fat for fear of the persistent infection by devascularized tissues. This led to the postoperative meningocele, the cerebrospinal fluid leak, and bacterial meningitis despite the successful abscess drainage. In case 2, tight sellar packing and reconstruction of the sellar wall were performed to avoid these postoperative complications, which resulted in complete drainage and uneventful postoperative course. Although accumulation of more cases is obviously needed to establish the definitive surgical technique in pituitary abscess surgery, our experience might suggest that packing of the sella is not impeditive for postoperative sufficient drainage.

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Dural suturing for repair of cerebrospinal fluid leak in transnasal transsphenoidal surgery

Acta Neurochirurgica ◽

10.1007/s00701-009-0406-2 ◽

2009 ◽

Vol 151 (11) ◽

pp. 1427-1430 ◽

Cited By ~ 26

Author(s):

Hiroshi Nishioka ◽

Hitoshi Izawa ◽

Yukio Ikeda ◽

Hiroaki Namatame ◽

Shinjiro Fukami ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Transsphenoidal Surgery ◽

Cerebrospinal Fluid Leak ◽

Dural Suturing ◽

Fluid Leak

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The Awake Endoscope-Guided Sealant Technique with Fibrin Glue in the Treatment of Postoperative Cerebrospinal Fluid Leak After Extended Transsphenoidal Surgery: Technical Note

World Neurosurgery ◽

10.1016/j.wneu.2013.01.017 ◽

2014 ◽

Vol 82 (3-4) ◽

pp. e479-e485 ◽

Cited By ~ 12

Author(s):

Luigi M. Cavallo ◽

Domenico Solari ◽

Teresa Somma ◽

Dragan Savic ◽

Paolo Cappabianca

Keyword(s):

Cerebrospinal Fluid ◽

Fibrin Glue ◽

Transsphenoidal Surgery ◽

Cerebrospinal Fluid Leak ◽

Technical Note ◽

Fluid Leak

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Endoscopic modified Lothrop procedure for repair of lateral frontal sinus cerebrospinal fluid leak

The Journal of Laryngology & Otology ◽

10.1017/s0022215108002326 ◽

2008 ◽

Vol 123 (1) ◽

pp. 145-147 ◽

Cited By ~ 9

Author(s):

J K Anverali ◽

A A Hassaan ◽

H A Saleh

Keyword(s):

Cerebrospinal Fluid ◽

Frontal Sinus ◽

World Literature ◽

Cerebrospinal Fluid Leak ◽

Lumbar Drain ◽

Alternative Approach ◽

Cerebrospinal Fluid Leaks ◽

Fluid Leak

AbstractObjective:To describe a previously unreported case of repair of a lateral frontal sinus cerebrospinal fluid leak, using the endoscopic modified Lothrop procedure.Method:Case report of new technique, with reference to the world literature.Results:An effective endoscopic, transnasal repair of a lateral frontal sinus cerebrospinal fluid leak was achieved in a 60-year-old man. The defect was closed with fat, fascia lata and free mucosal grafts. The left nasal cavity was packed and a lumbar drain left in situ post-operatively. The drain and packs were removed one week later and the patient discharged with no complications, and no recurrence at 12 months' follow up.Conclusion:Such cerebrospinal fluid leaks have traditionally been repaired using an external approach with osteoplastic flaps and obliteration of the sinus. We highlight the endoscopic modified Lothrop technique as an effective alternative approach to repair of cerebrospinal fluid leaks in poorly accessible areas of the frontal sinus.

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