Intraoperative CSF leaks can occur during endoscopic sellar surgery, especially in larger tumors or craniopharyngiomas. Once an intraoperative leak occurs, risk factors for postoperative leaks include craniopharyngiomas and higher BMI. Use of septal flaps decreases this risk.

Postoperative endoscopic pituitary adenoma surgery complications are associated with tumors with intraventricular extension, preoperative radiation, as well as common patient comorbidities. Identification of these factors may permit implementation of strategies to reduce postoperative complications.

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Intraoperative CSF leaks are a frequent and expected occurrence during endoscopic skull base surgery. Failed CSF leak repair has a significant impact on patient outcomes, with increased rates of postoperative pneumocephalus, intracranial infections, reoperation, deep vein thrombosis, readmission, and prolonged hospital stay. Recognition and repair of intraoperative CSF leaks reduces postoperative complications. Use of pedicled nasoseptal flaps improves outcomes in reconstructing defects at higher risk for postoperative leak.

Multiple factors contribute to disparities in head and neck cancer prevalence across the sociodemographic spectrum, including a lack of screening efforts in mostly underserved minority communities. African Americans and other ethnic minorities are at greater risk for late-stage diagnoses due to the lack of routine screenings and examinations. Advanced stage diagnosis profoundly limits treatment options, disease recovery, and survivorship. Differential access to care is frequently cited as contributing to delayed diagnosis in minority patients. Access to care is a complex concept that includes not only insurance status but also the equitable spatial distribution of health-care services. Recognizing this complexity, we explored the distribution of head and neck cancer cases seen at Grady Health System from 2010 to 2012 in order to identify geographic trends in disease prevalence compared to the distribution of oral health-care providers at the zip code level. We identified 53 cases of head and neck cancer spread across 36 zip codes primarily in the metropolitan Atlanta region. Geographic information systems analysis showed a spatial mismatch: increased disease prevalence and provider shortage in the mostly minority zip codes, and decreased disease prevalence and greater provider presence in the majority zip codes.