Turkish Neurosurgery 2021 , Vol 31 , Num 2
Fat and Fibrin Glue: Quo Vadis?
Juan F. VILLALONGA1,Domenico SOLARI2,Giulia GUIZZARDI2,Maria Rosaria SCALA2,Alvaro CAMPERO1
1Universidad Nacional de Tucumán, Facultad de Medicina, LINT, Tucumán, Argentina
2Università degli Studi di Napoli Federico II, Reproductive and Odontostomatological Sciences, Department of Neurosciences, Division of Neurosurgery, Naples, Italy
3Hospital Padilla, Servicio de Neurocirugía,Tucumán, Argentina
DOI : 10.5137/1019-5149.JTN.29712-20.2 AIM: To analyze the effectiveness of fat and fibrin glue to prevent postoperative cerebrospinal fluid (CSF) leak in pituitary surgery.

MATERIAL and METHODS: Two hundred and eleven patients affected by pituitary adenoma entered this study. Patients that underwent a microscopic transsphenoidal approach between January 2013 and April 2019 were included. All the patients that developed intraoperative CSF leak were treated with fat and fibrin glue. The presence or absence of postoperative CSF leak was considered as a parameter to test the effectiveness of the intraoperative reconstruction technique used.

RESULTS: Postoperative CSF leak was observed in 5 patients (2.4%). Among patients with an intraoperative low- grade CSF leak (1 or 2), 97.9% did not develop a postoperative CSF leak. In contrast, those who presented an intraoperative CSF leak of grade 3, had a worse prognosis.

CONCLUSION: Fat and fibrin glue is currently an effective method in the treatment of low-grade intraoperative CSF leak. In case of intraoperative CSF leak of grade 3, it should be used combined with the nasoseptal flap technique to obtain a safer reconstruction. Keywords : Cerebrospinal fluid leakage, Reconstructive phase, Pituitary surgery, Skull base

Corresponding author : Juan F. VILLALONGA, jfvillalonga@gmail.com