ISSN: 1300 - 6525 E-ISSN: 2149 - 0880
kulak burun boğaz
ve baş boyun cerrahisi dergisi
http://dergi.kbb-bbc.org.tr
Kayıtlı İndeksler








CASE REPORTS

Depending on Synthetic Graft Reason for Failure in Early Period in CSF Rinore Repair
Hazır Fasya Greftine Bağlı BOS Rinore Onarımında Erken Dönem Başarısızlık Nedeni
Received Date : 23 May 2020
Accepted Date : 31 Aug 2020
Available Online : 30 Oct 2020
Doi: 10.24179/kbbbbc.2020-76678 - Makale Dili: TR
KBB ve BBC Dergisi. 2021;29(1):65-8
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Endoscopic transsphenoidal pituitary surgery (ETSH) is a safe procedure,on the other hand a significant number of complications have been reported in many series. Cerebrospinal fluid leak, anterior pituitary insufficiency and diabetes insipitus are the most common complications. Our case was a fifty-year-old female patient who was admitted to the neurosurgery clinic due to her acromegalic facial appearance, diagnosed as pituitary macroadenoma and was repaired with artificial graft due to CSF leakage during ETSH operation. In this article, the case, which is thought to have developed rhinorrhea due to the failure of the graft used on the 10th postoperative day, and dura repair with fascia lata as an autogenous graft is presented in the light of the literature. In our opinion, we should be more careful in the choice of synthetic grafts for rhinorrhea repair of ETSH surgeries and the use of autogenous grafts should be prioritized.
ÖZET
Endoskopik transsfenoidal hipofiz cerrahisi (ETSH) güvenli bir prosedür olmasına rağmen birçok seride anlamlı sayıda komplikasyon bildirilmiştir. Beyin-omurilik sıvısı (BOS) rinore, anterior, hipofizer yetersizlik ve diabetes insipitus en sık görülen komplikasyonlardır. Olgumuz, akromegalik yüz görünümü nedeni ile beyin cerrahisi kliniğine başvurarak hipofiz makroadenomu tanısı konulan ve ETSH operasyonu sırasında BOS kaçağı nedeni ile yapay greftle onarım yapılan 50 yaşında kadın hastaydı. Bu yazımızda, postoperatif onuncu günde kullanılan greftin başarısızlığı nedeni ile rinorenin geliştiği düşünülen ve otojen greft olarak fasya lata ile dura onarımı tekrarlanan olgu literatür eşliğinde sunulmuştur. Kanımızca, ETSH cerrahilerinin rinore onarımında hazır greft tercihinde daha dikkatli davranılmalı ve otojen greft kullanımı ön planda tutulmalıdır.
KAYNAKLAR
  1. Dallapiazza RF, Jane Jr JA. Outcomes of endoscopic transsphenoidal pituitary surgery. Endocrinol Metab Clin North Am. 2015;44(1):105-15.[Crossref] [PubMed] 
  2. Ciric I, Ragin A, Baumgartner C, Pierce D. Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery. 1997;40(2):225-36.[Crossref] [PubMed] 
  3. Patel KS, Komotar RJ, Szentirmai O, Moussazadeh N, Raper DM, Starke RM, et al. Case-specific protocol to reduce cerebrospinal fluid leakage after endonasal endoscopic surgery. J Neurosurg. 2013;119(3):661-8.[Crossref] [PubMed] 
  4. Emanuelli E, Milanese L, Rossetto M, Cazzador D, d'Avella E, Volo T, et al. The endoscopic endonasal approach for cerebrospinal fluid leak repair in the elderly. Clin Neurol Neurosurg. 2015;132:21-5.[Crossref] [PubMed] 
  5. Cappabianca P, Cavallo LM, Valente V, Romano I, D'Enza AI, Esposito F, et al. Sellar repair with fibrin sealant and collagen fleece after endoscopic endonasal transsphenoidal surgery. Surg Neurol. 2004;62(3):227-33.[Crossref] [PubMed] 
  6. Burkett CJ, Patel S, Tabor MH, Padhya T, Vale FL. Polyethylene glycol (PEG) hydrogel dural sealant and collagen dural graft matrix in transsphenoidal pituitary surgery for prevention of postoperative cerebrospinal fluid leaks. J Clin Neurosci. 2011;18(11):1513-7.[Crossref] [PubMed] 
  7. Fiorindi A, Gioffrè G, Boaro A, Billeci D, Frascaroli D, Sonego M, et al. Banked fascia lata in sellar dura reconstruction after endoscopic transsphenoidal skull base surgery. J Neurol Surg B Skull Base. 2015;76(4):303-9.[Crossref] [PubMed] [PMC] 
  8. Saafan ME, Albirmawy OA, Tomoum MO. Sandwich grafting technique for endoscopic endonasal repair of cerebrospinal fluid rhinorrhoea. Eur Arch Otorhinolaryngol. 2014;271(5):1073-9.[Crossref] [PubMed] 
  9. Borsetto D, Ciorba A, Cazzador D, Volo T, Denaro L, D'Avellal ED, et al. Transnasal endoscopic management of anterior cerebrospinal fluid (CSF) leak: experience from a large case series. B-ENT. 2017;13(1 Suppl 27):15-21.[PubMed]