Cappabianca Paolo, Cavallo Luigi Maria, Esposito Felice, Valente Vinicio, De Divitiis Enrico
Department of Neurological Sciences, Division of Neurosurgery, "Federico II" University, Naples, Italy.
Neurosurgery. 2002 Dec;51(6):1365-71; discussion 1371-2.
To describe techniques and materials used in sellar repair after an endoscopic endonasal transsphenoidal approach.
Different techniques of sellar closure and indications for each specific condition are reviewed in a series of 170 consecutive patients.
Only 47 (27.6%) of 170 patients were considered candidates for sellar reconstruction after the endoscopic operation, mainly because of intraoperative cerebrospinal fluid leaks (14.1%). The overall rate of postoperative cerebrospinal fluid leakage was 2.3%, which was cured by means of an early reoperation in three cases and with lumbar drainage in the fourth case.
Reconstruction of the sella was considered necessary in only one-third of the patients who underwent operations via an endoscopic transsphenoidal procedure. Some minor expedients can be useful for the reconstruction, and the ideal material for the repair should be chosen.
描述鼻内镜下经鼻蝶入路术后鞍区修复所使用的技术和材料。
回顾了连续170例患者中不同的鞍区封闭技术及每种特定情况的适应证。
170例患者中只有47例（27.6%）在内镜手术后被认为适合鞍区重建，主要原因是术中脑脊液漏（14.1%）。术后脑脊液漏的总体发生率为2.3%，3例通过早期再次手术治愈，第4例通过腰椎引流治愈。
在内镜经蝶手术的患者中，仅三分之一的患者被认为有必要进行鞍区重建。一些小技巧对重建可能有用，应选择理想的修复材料。
