| Objectives To study a reliable method for avoiding cerebrospinal fluid rhinorrhea and sellar floor reconstruction after endoscopic endonasal transsphenoidal pituitary adenoma resection.Methods From June 2017 to June 2020,the clinical data of 98 patients with pituitary adenomas who underwent endoscopic endonasal transsphenoidal surgery in Neurosurgery Department of Hebei General hospital were analyzed retrospectively.According to the types of sellar floor reconstruction,42 patients were divided into two groups: fat packing + nasal septum mucosa flap + artificial dura for sellar floor reconstruction and 56 patients in control group for nasal septum mucosa flap + artificial dura for sellar floor reconstruction.The curative effect of the two groups was observed and compared,and the follow-up period was from 9 to 24 months.Results In the control group,56 cases(23 cases of pituitary microadenoma,28 cases of macroadenoma,5 cases of macroadenoma)underwent total resection in 51 cases and subtotal resection in 5 cases.There were 8 cases of diabetes insipidus,4 cases of intracranial infection,10 cases of cerebrospinal fluid rhinorrhea,3 cases of nasal bleeding and 3 cases of olfactory dysfunction.In the observation group,42 cases(17 cases of pituitary microadenoma,21 cases of macroadenoma,4 cases of macroadenoma),39 cases of total resection,3 cases of subtotal resection and 3 cases of subtotal resection were all macroadenoma patients.There were 4 cases of diabetes insipidus,2 cases of intracranial infection,2 cases of nasal bleeding,3 cases of olfactory dysfunction and 1 case of cerebrospinal fluid rhinorrhea.There was significant difference between the two groups(P < 0.05).Conclusions Fat packing plays an important role in sellar floor reconstruction and can effectively prevent cerebrospinal fluid rhinorrhea after operation.Resection of nasal septum mucosa flap may be the key to affect the function of nosebleed and olfaction.Figure4;Table2;Reference 185... |
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