[Repair and reconstruction of diaphragmatic defect during transcranial pituitary adenoma surgery].
OBJECTIVE
To investigate the application value of titanium-clip and artificial menigeal in the sella diaphragm repair and reconstruction during transcranial pituitary adenoma surgery.


METHODS
Thirty eight patients undergoing transcranial pituitary adenoma surgery received sella diaphragmatic defect repair and reconstruction after the removal of tumor, intraoperative diaphragmatic defect was classified as three grades, titanium-clip, artificial menigeal and EC glue were used for the sella diaphragmatic repair and reconstruction. The short-term and long-term complications were compared with those in the control group which contains 74 patients without diaphragmatic reconstruction.


RESULTS
As 14 to 46 months' follow-up in the diaphragmatic reconstruction group, there were no leakage of cerebrospinal fluid(CSF), infections, empty sella syndrome (ESS), optic nerve damage, and any other severe complications was found. Only one inter-sella hemorrhage without optic nerve damage was found 3 hours after surgery by CT scan. In the group without diaphragmatic reconstruction, more secondary empty sella, cerebrospinal fluid rhinorrhea and intra-cranial infection were found after the following transsphenoidal surgery (P < 0.05), there was one case underwent the 2nd time transcranial surgery 1 hours later due to severe inter-sella hemorrhage resulting in vision damage and conscious disturbance. There was no significant difference in pituitary function and vision improvement between the two groups as the occurrence of diabetes insipidus (P > 0.05).


CONCLUSIONS
It is important to repair the sellae diaphragm defect during transcranial pituitary adenoma surgery, which could reduce short-term and long-term complication.
Zhou
Pei-Zhi
PZ
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Cheng
Shu-Wen
SW
Yang
Zhang-Chao
ZC
Ma
Wei-Chao
WC
Dong
Wei
W
Peng
Li-Lei
LL
Jiang
Shu
S
D000236:Adenoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D001860:Bone Plates; D004652:Empty Sella Syndrome / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D007016:Hypophysectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D010911:Pituitary Neoplasms / Q000601:surgery*; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012658:Sella Turcica / Q000473:pathology / Q000601:surgery*; D055815:Young Adult