A new technique for clipping diaphragm defects in transsphenoidal surgery.
OBJECTIVE
To deal with postoperative CSF rhinorrhea, we developed a new technique using titanium/aneurysm clips to envelope the diaphragm defect to avoid postoperative CSF rhinorrhea.


METHODS
From January 2007 through December 2010, we used a new technique of clipping diaphragm defects to prevent CSF rhinorrhea in 57 of 510 patients (group 1) who underwent transsphenoidal surgery. The incidence of postoperative CSF rhinorrhea was compared with that of 245 patients who underwent transsphenoidal surgery before the usage of this clipping technique between January 2004 and December 2006 (group 2).


RESULTS
Postoperative CSF rhinorrhea developed in 8 (1.57%) patients of the 510 patients in group 1 while the new technique was used, while 17 (6.94%) patients of the 245 patients in group 2 developed CSF rhinorrhea before the usage of this technique (χ2 =14.907, P < .001). No device-related complication such as optical chiasm herniation after clipping the diaphragm defect was observed.


CONCLUSIONS
Clipping the diaphragm defect with the titanium/aneurysm clips is effective and practicable to prevent postoperative CSF rhinorrhea, it can also avoid unnecessary autologous tissue grafting and postoperative lumbar drainage.
West China Hospital, Department of Neurosurgery, Chengdu, China.
Zhou
Z
Peizhi
Tang
T
Jianjian
Zhang
Z
Ji
Li
L
Youping
Jiang
J
Shu
D000236:Adenoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D002559:Cerebrospinal Fluid Rhinorrhea / Q000000981:diagnostic imaging / Q000517:prevention & control*; D004388:Dura Mater / Q000601:surgery; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods*; D010911:Pituitary Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D011859:Radiography; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000601:surgery; D013525:Surgical Instruments; D014025:Titanium
D014025:Titanium