[The use of TachoComb for the rhinorrhea repair in pituitary transsphenoidal surgery].
The transsphenoidal pituitary tumors surgery is often connected with intraoperative rhinorrhea. This complication might be serious if occurs again in the postoperative period. The aim of this study is to evaluate the sella reconstruction methods in patients with intraoperative rhinorrhea and comparing of their efficiency.


METHODS
In the group of 259 consecutive cases operated on at the Neurosurgery Department in Cracow using the transsphenoidal approach, in 40 occured intraoperatively observed rhinorrhea. In the 26 cases we used Surgicel, artificial dura or fascia and Tissucol (I group), and in 14 TachoComb with Tissucol but in 5 also fascia or artificial dura (II group).


RESULTS
Out of the 26 patients from the I group (without TachoComb) in 5 cases occurred postoperatively rhinorrhea (3-36 days after surgery). 4 patients were reoperated, 1 patient died due to the meningitis. 2 patients suffered from the visual disturbances due to the sella overpacking (7,7%), what was visualized in the control imaging studies. In 14 cases from the II group in 2 postoperative rhinorrhea was observed (in the 7 and the 30 day after operation)--14,2%. There were no signs of meningitis, and no fatal cases. The visual disturbances as well as overpacking of the sella were not observed.


CONCLUSIONS
Using of the TachoComb in reconstructive surgery of the sella reduces the risk of the post operative CSF leak and eliminates the features of the sella overpacking and visual deterioration.
Czepko
Ryszard
R
Klinika Neurochirurgii Collegium Medium UJ w Krakowie. rczepko@poczta.onet.pl
Kwinta
Borys
B
D000236:Adenoma / Q000601:surgery*; D007611:Aprotinin / Q000627:therapeutic use*; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000517:prevention & control*; D004338:Drug Combinations; D004724:Endoscopy / Q000379:methods*; D005069:Evaluation Studies as Topic; D005340:Fibrinogen / Q000627:therapeutic use*; D006488:Hemostasis, Surgical; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods; D010902:Pituitary Gland / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery; D010911:Pituitary Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012658:Sella Turcica / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery; D013917:Thrombin / Q000627:therapeutic use*
D004338:Drug Combinations; C093991:tachocomb; D005340:Fibrinogen; D007611:Aprotinin; D013917:Thrombin