title: [Cerebrospinal fluid rhinorrhea following endocopic trans-sphenoidal pituitary surgery: Experience from 337 patients].
abstract: BACKGROUND
  Cerebrospinal fluid (CSF) leak is a frequent complication after trans-sphenoidal pituitary surgery. We try to determine the incidence, risk factors, diagnostic procedures, and management of CSF leaks following trans-sphenoidal pituitary macroadenoma surgery.
  
  
  METHODS
  A retrospective analysis of 337 patients data.
  
  
  RESULTS
  Postoperative CSF leaks occurred in 11 patients (3,1%). Ten patients had to be reoperated. Three patients had meningitis. Intraoperative CSF leak is the only significant predictive factor of postoperative CSF leak. Revision surgery, wide opening of the sella turcica and insufficient reconstruction of the sellar floor also seem to play a role (for six cases of postoperative CSF leak, the closure material had been excluded).
  
  
  CONCLUSIONS
  Prevention of the postoperative CSF leak needs screening of intra-operative CSF leak. The strength of the sellar floor is essential in order to avoid the ejection of the closure material, related to the intracranial pression.
authors.affiliation: Service de neurochirurgie, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France. jduntze@chu-reims.fr
authors.forename: J
authors.initials: J
authors.lastname: Duntze
authors.forename: C F
authors.initials: CF
authors.lastname: Litré
authors.forename: T
authors.initials: T
authors.lastname: Graillon
authors.forename: R
authors.initials: R
authors.lastname: Maduri
authors.forename: G
authors.initials: G
authors.lastname: Pech-gourg
authors.forename: P
authors.initials: P
authors.lastname: Rakotozanany
authors.forename: R
authors.initials: R
authors.lastname: Gras
authors.forename: H
authors.initials: H
authors.lastname: Dufour
mesh_terms: D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology* / Q000517:prevention & control; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D007432:Intraoperative Period; D008581:Meningitis / Q000150:complications; D010902:Pituitary Gland / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D012658:Sella Turcica / Q000601:surgery; D013100:Sphenoid Bone / Q000601:surgery*; D014057:Tomography, X-Ray Computed