Abstract
Background and objectives: In the majority of pituitary adenectomy surgeries, postoperative cerebrospinal fluid leaking is a challenge. Clinical professionals must prioritize the identification of particular risk factors and the resolution of this condition. The major goal of this study is to standardize the existing prevalence, risk, and outcome of cereberospinal fluid leak following trans-sphenoidal pituitary adenectomy.
Methods: This retrospective cohort study was performed in Shahid Dr. Aso and Shar Hospitals, Sulaimani, Kurdistan Region, Iraq, from 10th, January 2021 to 10th, January 2023, on 95 consecutive patients with trans nasal transsphenoidal microsurgical resection for pituitary adenoma. They comprised of 52 female patients and 43male patients from different age groups. The secreting adenomas were 56 cases, and non-secreting adenomas were 39 cases, all underwent trans nasal transsphenoidal microsurgical resection for pituitary adenoma to evaluate the prevalence, risk and outcome of cerebrospinal fluid leakage afterwards.
Results: In a total of 95 cases, postoperatively 4 cases had cerebrospinal fluid leak, intra-operatively diaphragma was opened in 6 cases, 4 developed cerebrospinal fluid leaks. All of the cases were Macroadenomas, of which 3 were secretary Macroadenomas and 1 was non-secretary Macroadenoma. There was no statistically significant association between the tumor size (macroadenoma) and cerebrospinal fluid leakage. There was statistically significant (p value was 0.036) association between the surgical causes (Haddad flap) and cerebrospinal fluid leakage.
Conclusions: Cerebrospinal fluid leaks are common post operative complication of trans-sphenoidal surgery for pituitary adenoma, in which taking pedicle (Haddad) flap during the surgery is considered to reduce this post operative complication.