Sellar Diaphragm Reconstruction with Tachosil During Endoscopic Endonasal Surgery: Technical Note

Jiménez Zapata, Herbert Daniel
Berrocal, Víctor Rodríguez
Vior Fernández, Carlos
Sánchez, Franklin Mariño
Fernández, Alfredo García

¹ Department of Neurosurgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
² Department of Rhinology, Hospital Universitario Ramón y Cajal, Madrid, Spain
³ Department of Rhinology, Hospital Universitario HM Puerta del Sur, Madrid, Spain

Address for correspondence Dr. Herbert Daniel Jiménez Zapata, MD Pozanos St, n° 7, 1°-B, Burgos Spain and Department of Neurosurgery, Hospital Universitario Ramón y Cajal, Madrid Spain

(e-mail: [email protected]).

received January 21, 2019

accepted after revision March 23, 2019

published online May 28, 2019

Journal of Neurological Surgery Part B : Skull Base 81(3):p 275-279, June 2020. | DOI: 10.1055/s-0039-1688781

Abstract

This report introduces a new closure technique for the management of intraoperative cerebrospinal fluid (CSF) leakage during endoscopic endonasal surgery. The procedure is based on the combination of a traditional autologous tissue flap with a heterologous fibrin graft (TachoSil). We performed a retrospective analysis on 121 patients with pituitary adenomas treated in our center by the senior neurosurgeon (author V.R.B) in the previous 4 years. Only one patient (0.8%) developed a CSF leakage and no adverse events were found related to the use of TachoSil. Compared with other techniques used previously, sellar diaphragm reconstruction with TachoSil seems to be an effective and inexpensive alternative.