The sellar barrier and intraoperative CSF leak in elderly patients

•Cerebrospinal fluid leak is a significant complication in pituitary surgery.•The majority of our patients presented a strong barrier.•CSF leak was statistically more likely in patients with weak sellar barrier.•The concept of the sellar barrier is also valid in elderly patients. Cerebral spinal flu...

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Bibliographic Details
Published in:Journal of clinical neuroscience 2020-03, Vol.73, p.48-50
Main Authors: Centeno, Tomás Ries, Villalonga, Juan F., Saenz, Amparo, Del Pont, Francisco Marcó, Cervio, Andrés, Campero, Alvaro
Format: Article
Language:English
Subjects:
Cerebrospinal fluid
Neurosurgical procedures
Pituitary Gland
Pituitary neoplasms
Skull base
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Summary:•Cerebrospinal fluid leak is a significant complication in pituitary surgery.•The majority of our patients presented a strong barrier.•CSF leak was statistically more likely in patients with weak sellar barrier.•The concept of the sellar barrier is also valid in elderly patients. Cerebral spinal fluid (CSF) leak is a significant complication in pituitary surgery, increasing both patient morbidity and mortality. In a recent publication, Campero et al. observed worse postoperative prognosis and increased risk of intraoperative CSF leak in patients with reduced sellar barrier thickness. The objective of this study was to analyze the association between sellar barrier thickness and intraoperative CSF leak in older individuals. A retrospective review was conducted of 44 transsphenoidal surgery resections for pituitary adenomas, 24 microscopic and 20 purely endoscopic procedures. Presence of intraoperative CSF fistula was significantly greater in patients with weak sellar barrier (thickness under 1 mm), compared to strong sellar barrier (52.94% vs 3.70% p 
ISSN:0967-5868
1532-2653
DOI:10.1016/j.jocn.2020.01.078