Use of Acellular Dermal Allograft for Sellar Reconstruction after Endoscopic Transsphenoidal Resection of Pituitary Tumors

• Main Authors: Hattar, Ellina, Mendelson, Zachary S., Eloy, Jean A., Liu, James
• Format: Conference Proceeding
• Language: English
• ISSN: 2193-6331; 2193-634X
• DOI: 10.1055/s-0034-1370456

Objective : This study aims to investigate the efficacy of acellular dermal allograft (AlloDerm) as a primary repair material for sellar reconstruction after endoscopic transsphenoidal resection of pituitary tumors. We describe our repair technique using AlloDerm and report our incidence of postoperative cerebrospinal fluid (CSF) leak. Methods : Retrospective review of our endoscopic skull base surgery database revealed 79 cases of standard endoscopic endonasal transsphenoidal surgery (EETS) performed for the resection of pituitary and/or parasellar lesions. Group A (AlloDerm group) comprised 27 cases in which AlloDerm was used as the primary repair material for sellar reconstruction. The remaining 52 cases were included in Group B (non-AlloDerm group). For these 52 cases, other materials, such as fat graft, fascia lata graft, and/or pedicled nasoseptal flap, were used as the primary material for sellar reconstruction. Results : The postoperative CSF leak rate for both groups was 0% following EETS. Ten (37.0%) intraoperative CSF leaks were observed in group A, while 37 (71.2%) intraoperative CSF leaks were repaired with other primary repair materials (Group B). High flow CSF leaks were observed in 1 (3.7%) case in group A, and 6 (11.5%) cases in group B. Group B was found to have a significantly higher incidence of intraoperative CSF leak ( p  = 0.0179). Group A showed a significant reduction in the use of autologous fat grafts ( p