Meeting abstract
CSF Leaks after Endoscopic Skull Base Surgery: A Single Institution Experience
Marcel Marjanović Kavanagh
orcid.org/0000-0001-9084-6787
; Klinika za bolesti uha, nosa i grla i kirurgiju glave i vrata, KBC Zagreb, Kišpatićeva 12, 10000 Zagreb, Hrvatska
Katarina Đurić-Vuković
orcid.org/0000-0003-4763-6711
; Klinika za bolesti uha, nosa i grla i kirurgiju glave i vrata, KBC Zagreb, Kišpatićeva 12, 10000 Zagreb, Hrvatska
Vjerislav Peterković
orcid.org/0000-0003-4763-6711
; Klinika za neurokirurgiju, KBC Zagreb, Kišpatićeva 12, 10000 Zagreb, Hrvatska
Ante Melada
; Klinika za neurokirurgiju, KBC Zagreb, Kišpatićeva 12, 10000 Zagreb, Hrvatska
Abstract
Objective: To review our experience with endoscopic endonasal skull base reconstruction.
Materials and Methods: A retrospective review of a single-institution endoscopic endonasal patient database from 2014-2019. The CSF leaks were graded based on defect size from 0 (no leak) to 2. The reconstruction method was documented for all patients.
Results: There were in total 341 endoscopic endonasal operations for performed parasellar pathology. The pathology was: pituitary adenomas (85%), craniopharyngioma (1.1%), meningioma (2.9%), malignant tumors (0.5%) and other (9.9%). The total postoperative CSF leaks rates were 8.7%, and meningitis rates were 4.4%. The vast majority of CSF leaks were in the first 2 years of endoscopic endonasal skull base surgery. The flaps that were used: nasoseptal flap, middle turbinate flap (vascularized), free mucosal graft, fat graft and fat plug and the combination of these matherials.
Conclusion: Reconstruction of skull base defects is of uttermost importance in the prevention of meningitis. There is a slow learning curve in achieving the surgical skills for endoscopic endonasal skull base surgery. The nasoseptal flap is the “work-horse” for anterior skull base reconstruction.
Keywords
CSF leak; endoscopic skull base; nasoseptal flap; parasellar endoscopic surgery
Hrčak ID:
234566
URI
Publication date:
27.2.2020.
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