Skull base reconstruction in the extended endoscopic transsphenoidal approach for suprasellar lesions

dc.creatorCavallo, LM
dc.creatorMessina, A
dc.creatorEsposito, F
dc.creatorde Diviths, O
dc.creatorDal Fabbro, M
dc.creatorde Diviths, E
dc.creatorCappabianca, P
dc.date2007
dc.dateOCT
dc.date2014-11-18T07:31:58Z
dc.date2015-11-26T16:52:29Z
dc.date2014-11-18T07:31:58Z
dc.date2015-11-26T16:52:29Z
dc.date.accessioned2018-03-28T23:39:26Z
dc.date.available2018-03-28T23:39:26Z
dc.identifierJournal Of Neurosurgery. Amer Assoc Neurological Surgeons, v. 107, n. 4, n. 713, n. 720, 2007.
dc.identifier0022-3085
dc.identifierWOS:000249746500001
dc.identifier10.3171/JNS-07/10/0713
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/74338
dc.identifierhttp://www.repositorio.unicamp.br/handle/REPOSIP/74338
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/74338
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1276293
dc.descriptionObject. The extended transsphenoidal approach to the suprasellar region has the advantages of minimal invasiveness and brain manipulation in the surgical treatment of small to medium lesions. At the same time, however, it carries a higher risk of postoperative cerebrospinal fluid (CSF) leakage and related complications than those for the standard transsphenoidal approach. Effective reconstruction of large skull base defects is a major concern in such extended approaches and remains challenging. Methods. Between January 2004 and April 2006, 21 patients affected by different suprasellar lesions underwent the extended endoscopic endonasal transtuberculum-transplanum approach. Three different techniques were used for the skull base reconstructions. In all cases, dehydrated human pericardium (Tutoplast) for dural reconstruction and a copolymer Of L-lactic acid and glycolic acid (LactoSorb) as a bone Substitute were used. Collagen sponges, fibrin glue, and an inflated Foley balloon catheter were also used to fill the sphenoid sinus cavity. Results. Two cases of postoperative CSF leaks (9.5%) and one case of mycotic sinusitis (4.8%) occurred following the intradural (inlay) and intraextradural (inlay-overlay) graft positioning. No cases of postoperative CSF leakage occurred in cases in which the extradural-only reconstruction procedure was applied. No meningitis or other complications related to the closure were noticed. Conclusions. The rate of postoperative CSF leakage after an extended approach to the suprasellar area is higher compared with that following standard pituitary surgery. Reconstruction after craniopharyngioma surgery exposes patients to an increased risk of postoperative CSF leaks. The extradural (overlay) technique was found to be the most effective in assuring a watertight closure.
dc.description107
dc.description4
dc.description713
dc.description720
dc.languageen
dc.publisherAmer Assoc Neurological Surgeons
dc.publisherCharlottesville
dc.publisherEUA
dc.relationJournal Of Neurosurgery
dc.relationJ. Neurosurg.
dc.rightsfechado
dc.sourceWeb of Science
dc.subjectcerebrospinal fluid leak
dc.subjectendoscopic transsphenoidal surgery
dc.subjectextended endoscopic transsphenoidal approach
dc.subjectskull base reconstruction
dc.subjectskull base surgery
dc.subjectSellar Floor Reconstruction
dc.subjectTechnical Note
dc.subjectSilicone Plate
dc.subjectZygomatic Fractures
dc.subjectPituitary-adenomas
dc.subjectFixation Devices
dc.subjectFibrin Glue
dc.subjectSurgery
dc.subjectExperience
dc.subjectTumors
dc.titleSkull base reconstruction in the extended endoscopic transsphenoidal approach for suprasellar lesions
dc.typeArtículos de revistas


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