Comparison of Cerebrospinal Fluid Leakage in Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Adenoma with and without Sellar Floor Reconstruction


  • Muhammad Naveed Majeed Punjab Institute of Neurosciences
  • Sumira Kiran Department of Neurosurgery Unit III, Punjab Institute of Neurosciences (PINS), Lahore
  • Tariq Imran Khokhar Department of Neurosurgery Unit III, Punjab Institute of Neurosciences (PINS), Lahore
  • Mubashir Malik Department of Neurosurgery Unit III, Punjab Institute of Neurosciences (PINS), Lahore
  • Zubair Mustafa Khan
  • Asif Bashir Department of Neurosurgery Unit III, Punjab Institute of Neurosciences (PINS), Lahore



Pituitary Adenoma, Endoscopic Endonasal Transsphenoidal Surgery, Cerebrospinal Fluid Leakage


Objectives:  This study aimed to compare CSF leak in endoscopic endonasal TSS of pituitary adenoma with and without reconstruction of the sellar floor with no intraoperative CSF leakage.

Materials and Methods:  It was a randomized controlled trial of 116 patients of both genders diagnosed case of pituitary adenoma who underwent endoscopic endonasal TSS over 1 year. The cases were randomized into 2 groups. In Group A endoscopic endonasal TSS and the sellar floor, reconstruction was done while in Group B only endoscopic endonasal transsphenoidal surgery was done without reconstruction.

Results:  The patient’s mean age in group A was 40.7 ± 9.56 years, and in group, B was 41.9 ± 10.5 years. The gender distribution, for group A, males and females were 29 each (50%) and in group B, the males were 36 (62%) and females were 22 (38%). There were 52 (89.7%) cases of macroadenoma and 6 (10.3%) cases of microadenoma in each group. On the 1st postoperative day, CSF leakage was noted in 2 (3.4%) patients of group A, and CSF leakage was observed in 2 (3.4%) patients of group B. Results revealed no difference in CSF leakage between both groups. There were minor nasal complications in both groups.

Conclusion:  There is an equal chance of success with endoscopic endonasal transsphenoidal surgery (TSS) of pituitary adenoma with and without reconstruction of the sellar floor, concerning post-operative CSF leak, in patients who have no intraoperative CSF leak which enlarges the pool of options for treatment.


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