Sellar floor reconstruction after transsphenoidal surgery using fibrin glue without grafting or implants: technical note

Sedá, L; Câmara, Ródio Brandão; Cukiert, Arthur; Burattini, José Augusto; Mariani, Pedro Paulo

doi:10.1016/j.surneu.2005.10.021

Cited by 53 publications

(33 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Transsphenoidal surgery is widely recognized as the optimal approach for resection of sellar or suprasellar tumors 12) because of its short operation time, simple surgical procedures, and low associated morbidities 13) . Despite modern advances in surgical technique and increased expertise of neurosurgeons, sellar reconstruction remains challenging 9) .…”

Section: Discussionmentioning

confidence: 99%

“…Despite modern advances in surgical technique and increased expertise of neurosurgeons, sellar reconstruction remains challenging 9) . Several methods for sellar reconstruction have been proposed to prevent CSF leaks 3,4,9,10,13,14) . The use of autologous tissue is highly recommended to enhance the outcome for sellar reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…To date, numerous attempts have been made to reconstruct sellar defects such as free graft using the fat tissue or fascia lata, packing of collagen sponge, and the use of a variety of solid or semisolid buttress materials such as autologous cartilage and bone, absorbable plates, and nonabsorbable silicone and titanium plates or mesh 2,5,10,11,13) However, when used as dural substitutes, autologous tissues such as abdominal fat or tensor fascia lata require additional skin incisions and prolonged operative time 2) . In addition, autologous septal bone is irregularly shaped and bony reconstruction is difficult to apply as a buttress.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Clinical Efficacy of Radiation-Sterilized Allografts for Sellar Reconstruction after Transsphenoidal Surgery

Kim

Jeon

Kong

et al. 2011

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Objective : The aim of this study was to assess the safety and efficacy of radiation-sterilized allografts of iliac bone and fascia lata from cadaver specimens to repair skull base defects after transsphenoidal surgery. Methods : Between May 2009 and January 2010, 31 consecutive patients underwent endonasal transsphenoidal surgery and all patients received sellar reconstruction using allografts following tumor removal. The allografts were obtained from the local tissue bank and harvested from cadaver donors. The specimens used in our approach were tensor fascia lata and the flat area of iliac bone. For preparation, allografts were treated with gamma irradiation after routine screening by culture, and then stored at -70°C. Results : The mean follow-up period after surgery was 12.6 months (range, 7.4-16 months). Overall, postoperative cerebrospinal fluid (CSF) leaks occurred in three patients (9.7%) and postoperative meningitis in one patient (3.2%). There was no definitive evidence of wound infection at the routine postoperative follow-up examination or during re-do surgery in three patients. Postoperative meningitis in one patient was improved with the use of antibiotics and prolonged CSF diversion. Conclusion : We suggest that allograft materials can be a feasible alternative to autologous tissue grafts for sellar reconstruction following transsphenoidal surgery under selected circumstances such as no or little intraoperative CSF leaks.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Clinical Efficacy of Radiation-Sterilized Allografts for Sellar Reconstruction after Transsphenoidal Surgery

Kim

Jeon

Kong

et al. 2011

J Korean Neurosurg Soc

View full text Add to dashboard Cite

show abstract

“…This was considered to be an essential part of the procedure regardless of the presence or absence of a CSF leak (16)(17)(18), although recent data support that there is no need to reconstruct the bony defect of sella when there is no intraoperative CSF leak (2,5,9,4). Adopting this discipline especially in the case of RCCs could help in drainage of the cyst secretion and reduce the risk of recurrence therefore the sellar reconstruction is not recommended in cases of RCCs without intraoperative CSF leak (21).…”

Section: Discussionmentioning

confidence: 99%

Third ventricle herniation into the sphenoid sinus following endoscopic transnasal transsphenoidal fenestration of rathke's cleft cyst

Jalessi¹,

Sharifi²,

Jahanbakhshi³

et al. 2012

Turkish Neurosurgery

View full text Add to dashboard Cite

Rathke cleft cyst (RCC) is an uncommon albeit benign sellar lesion with an incidence rate of between 2 to 33%. RCCs are usually asymptomatic except in the large cases whit suprasellar extension. We herein describe a unique case of RCC, which presented with severe visual loss owing to massive herniation of the optic chiasm and third ventricle down into the sphenoid sinus through a small 8×8 mm foramen after transnasal endoscopic surgical fenestration and marsupialization of the cyst. We describe a reconstruction method via endonasal transsphenoidal approach in this case and suggest prophylactic reconstruction of the sellar floor in sellar lesions with equal or more voluminous suprasellar extensions that are susceptible to such massive herniation and secondary empty sella syndrome.KeywOrds: Rathke cleft cysts, Sella turcica, Secondary empty sella syndrome ÖZRathke yarığı kisti nadir ve benign bir sellar lezyon olup insidansı %2 ila 33 arasındadır. Rathke yarığı kistleri genellikle suprasellar uzantılı büyük olgular dışında asemptomatiktir. Burada optik kiazm ve üçüncü ventrikülün transnazal endoskopik cerrahi ile fenestrasyon ve kist marsüpializasyonundan sonra küçük 8x8 mm bir foramen içinden sfenoid sinüse masif herniasyonu nedeniyle şiddetli görme kaybıyla gelen benzersiz bir Rathke yarığı kisti olgusu sunuyoruz. Bu olguda endonazal transsfenoidal yaklaşımla bir rekonstrüksiyon yöntemi öneriyor ve bu tür masif herniasyon ve sekonder boş sella sendromuna yatkın olan eşit derecede veya daha hacimli suprasellar uzantılara sahip sellar lezyonlarda, sella tabanının profilaktik olarak rekonstrüksiyonunu öneriyoruz.AnAhtAr sÖZCÜKler: Rathke yarığı kistleri, Sella tursika, Sekonder boş sella sendromu

show abstract

“…Transsphenoidal surgery has been repeatedly reported as a safe and effective method for pituitary tumor resection; however, it is not without risks and potential complications [2][3][4][5]. Persistent postoperative cerebrospinal fluid (CSF) leakage is a major cause of morbidity following transsphenoidal surgery for pituitary adenomas [2,[6][7][8]. A national study, examining complications of transsphenoidal surgery, cites the incidence of postoperative CSF leak to be 3.9% [9].…”

Section: Introductionmentioning

confidence: 99%

Perioperative Cerebrospinal Fluid Diversion Utilizing Lumbar Drains in Transsphenoidal Surgery

Shah¹

2013

J Neurol Disord

View full text Add to dashboard Cite

Sellar floor reconstruction after transsphenoidal surgery using fibrin glue without grafting or implants: technical note

Cited by 53 publications

References 17 publications

Clinical Efficacy of Radiation-Sterilized Allografts for Sellar Reconstruction after Transsphenoidal Surgery

Clinical Efficacy of Radiation-Sterilized Allografts for Sellar Reconstruction after Transsphenoidal Surgery

Third ventricle herniation into the sphenoid sinus following endoscopic transnasal transsphenoidal fenestration of rathke's cleft cyst

Perioperative Cerebrospinal Fluid Diversion Utilizing Lumbar Drains in Transsphenoidal Surgery

Contact Info

Product

Resources

About