Prevention of cerebrospinal fluid rhinorrhea during mononostril-transsphenoidal operation of pituitary adenomas

Objective To discuss the prevention of cerebrospinal fluid rhinorrhea during mononostril-transsphenoidal operation of pituitary adenomas.Methods Four hundred and sixty-four patients with pituitary adenomas,admitted to our hospital from February 2000 to October 2013 and operated by mononostril-transsphenoidal approach,were chosen in our study; their clinical data,surgical methods and effects were retrospectively analyzed,and the reasons of cerebrospinal fluid rhinorrhea and their prognoses were evaluated.Results Cerebrospinal fluid rhinorrhea occurred in 31 patients,19 of them caused by tumor removal management and seven caused by damage of diaphragma sellae following tumor falling off,one duo to fast slipping off the tumor and 3 due to incorrect resection of the bone and (or) dura in the base of the sella.All patients were cured by management during and after the operations,without second surgery.Conclusion According to the pre-operative CT or MR images of the tumors,precise judgment and resection of the bone and(or) dura in the base of the sella and removal of the tumors with prompt procedure may prevent the occurrence of cerebrospinal fluid rhinorrhea. Key words: Transsphenoidal approach;  Pituitary adenoma;  Cerebrospinal fluid rhinorrhea