USE OF ARTIFICIAL BONE OF TRICALCIUM PHOPHATE IN SELLAR FLOOR RECONSTRUCTION AFTER TRANSSPHENOIDAL MICROSURGERY FOR PITUITARY ADEOMA_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CUIPeng ¹ , WEIHui ² , LIANZhigang ¹ , DONGBin ¹ ,  ZHAOYongshun ¹

1. Department of Neurosurgery, First Affiliated Hospital of Dalian Medical University, Dalian Liaoning, 116011, P. R. China;
2. Department of Hand Surgery, the 3rd People's Hospital of Dalian City;

Corresponding author：

ZHAOYongshun, Email: 18098876131@163.com

Keywords：

Pituitary adenoma resection; Transsphenoidal approach; Sellar floor reconstruction; Cerebrospinal leakage

DOI：

10.7507/1002-1892.20150301

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Objective To explore the effectiveness of the usage of artificial bone of tricalcium phophate in sellar floor reconstruction after transsphenoidal microsurgery for pituitary adeoma. Methods Between January and December 2014, 85 patients with pituitary adema underwent transsphenoidal microsurgery, and the clinical data were retrospectively analyzed. "Sandiwich" was used for sellar floor reconstruction in 46 cases (control group), and "sandiwich" combined with the artificial bone of tricalcium phophate in 39 cases (trial group). There was no significant difference in gender, age, disease duration, size of tumor, invasiveness, and the degree of damage to the sellar floor between 2 groups (P>0.05). Results Total removal and subtotal removal of tumors were achieved in 39 cases and 7 cases of the control group, and in 33 cases and 6 cases of the trial group, showing no significant difference between 2 groups (Z=-1.303, P=0.193). Cerebrospinal leakage occurred in 8 cases of the control group and in 10 cases of the trial group during operation, showing no significant difference (Z=-1.748, P=0.080). The case number of cerebrospinal leakage in the control group (4 cases) was significantly more than that in the trial group (0) after operation (P=0.020). The time of gauze removal in the trial group (3 days) was significant shorter than that in the control group[(4.3±1.6) days] (t=2.236, P=0.033). The patients were followed up 3-14 months in the control group and 5-13 months in the trial group. No cerebrospinal leakage occurred during follow-up. Conclusion Sellar floor reconstruction with artificial bone of tricalcium phophate is safe, and it can reduce cerebrospinal leakage and shorten the time of gauze removal.

Citation： CUIPeng, WEIHui, LIANZhigang, DONGBin, ZHAOYongshun. USE OF ARTIFICIAL BONE OF TRICALCIUM PHOPHATE IN SELLAR FLOOR RECONSTRUCTION AFTER TRANSSPHENOIDAL MICROSURGERY FOR PITUITARY ADEOMA. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(11): 1405-1407. doi: 10.7507/1002-1892.20150301 Copy

1.	Berker M, Hazer DB, Yücel T, et al. Complications of endoscopic surgery of the pituitary adenomas:analysis of 570 patients and review of the literature. Pituitary, 2012, 15(3):288-300.
2.	Ivan ME, Bryan lorqulescu J, EI-Sayed I, et al. Risk factors for postoperative cerebrospinal fluid leak after endonasal surgery. J Clic Neurosci, 2015, 22(1):48-54.
3.	Jalessi M, Sharifi G, Mirfallah Layalestani MR, et al. Sellar reconstruction algorithm in endoscopic transsphenoidal pituitary surgery:experience with 240 cases. Med J Islam Repub Iran, 2013, 27(4):186-194.
4.	Yildirim AE, Dursun E, Ozdol C, et al. Using an autologous fibrin sealant in the prenventing of cerebrospinal fluid leak with large skull base defect following endoscopic endonasal transsphenoidal surgery. Tur Neurosurg, 2013, 23(6):736-741.
5.	Rivera-Serrano CM, Snyderman CH, Gardner P, et al. Nasoseptal "rescue" flap:a novel modification of the nasoseptal flap technique for pituitary surgery. Laryngoscope, 2011, 121(5):990-993.
6.	Tabaee A, Kamat A, Shrivastava R. Complex reconstruction of the sella using absorbable mini-plate in revision endoscopic pituitary surgery:technical note. J Neurol Surg A Cent Eur Neurosurg, 2013, 74(5):313-317.
7.	Horridge M, Jesurasa A, Olubajo F, et al. The use of the nasoseptal flap to reduce the rate of post-operative cerebrospinal fluid leaks following endoscopic trans-sphenoidal surgery for pituitary disease. Br J Neurosurg, 2013, 27(6):739-741.
8.	Hsu YW, Ho CY, Yen YS. Reconstructed bone chip detachment is a risk for sinusitis after transsphenoidal surgery. Laryngoscope, 2014, 124(1):57-61.
9.	Liebelt BD, Huang M, Baskin DS. Sellar floor reconstruction with the medpor implant versus autologous bone after transnasal transsphenoidal surgery:Outcome in 200 consecutive patients. World Neurosurg, 2015, 2:240-245.
10.	Jakimovski D, Bonci G, Attia M, et al. Incidence and significance of intraoperative cerebrospinal fluid leak in pituitary surgery using intrathecal fluorescein. World Neurosurg, 2014, 82(3-4):e513-523.

1. Berker M, Hazer DB, Yücel T, et al. Complications of endoscopic surgery of the pituitary adenomas:analysis of 570 patients and review of the literature. Pituitary, 2012, 15(3):288-300.
2. Ivan ME, Bryan lorqulescu J, EI-Sayed I, et al. Risk factors for postoperative cerebrospinal fluid leak after endonasal surgery. J Clic Neurosci, 2015, 22(1):48-54.
3. Jalessi M, Sharifi G, Mirfallah Layalestani MR, et al. Sellar reconstruction algorithm in endoscopic transsphenoidal pituitary surgery:experience with 240 cases. Med J Islam Repub Iran, 2013, 27(4):186-194.
4. Yildirim AE, Dursun E, Ozdol C, et al. Using an autologous fibrin sealant in the prenventing of cerebrospinal fluid leak with large skull base defect following endoscopic endonasal transsphenoidal surgery. Tur Neurosurg, 2013, 23(6):736-741.
5. Rivera-Serrano CM, Snyderman CH, Gardner P, et al. Nasoseptal "rescue" flap:a novel modification of the nasoseptal flap technique for pituitary surgery. Laryngoscope, 2011, 121(5):990-993.
6. Tabaee A, Kamat A, Shrivastava R. Complex reconstruction of the sella using absorbable mini-plate in revision endoscopic pituitary surgery:technical note. J Neurol Surg A Cent Eur Neurosurg, 2013, 74(5):313-317.
7. Horridge M, Jesurasa A, Olubajo F, et al. The use of the nasoseptal flap to reduce the rate of post-operative cerebrospinal fluid leaks following endoscopic trans-sphenoidal surgery for pituitary disease. Br J Neurosurg, 2013, 27(6):739-741.
8. Hsu YW, Ho CY, Yen YS. Reconstructed bone chip detachment is a risk for sinusitis after transsphenoidal surgery. Laryngoscope, 2014, 124(1):57-61.
9. Liebelt BD, Huang M, Baskin DS. Sellar floor reconstruction with the medpor implant versus autologous bone after transnasal transsphenoidal surgery:Outcome in 200 consecutive patients. World Neurosurg, 2015, 2:240-245.
10. Jakimovski D, Bonci G, Attia M, et al. Incidence and significance of intraoperative cerebrospinal fluid leak in pituitary surgery using intrathecal fluorescein. World Neurosurg, 2014, 82(3-4):e513-523.

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Chinese Journal of Reparative and Reconstructive Surgery

USE OF ARTIFICIAL BONE OF TRICALCIUM PHOPHATE IN SELLAR FLOOR RECONSTRUCTION AFTER TRANSSPHENOIDAL MICROSURGERY FOR PITUITARY ADEOMA

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