Sellar repair in endoscopic endonasal transsphenoidal surgery: results of 170 cases

Objective: To describe techniques and materials used in sellar repair after an endoscopic endonasal transsphenoidal approach. Methods: Different techniques of sellar closure and indications for each specific condition are reviewed in a series of 170 consecutive patients. Results: Only 47 (27.6%) of 170 patients were considered candidates for sellar reconstruction after the endoscopic operation, mainly because of intraoperative cerebrospinal fluid leaks (14.1%). The overall rate of postoperative cerebrospinal fluid leakage was 2.3%, which was cured by means of an early reoperation in three cases and with lumbar drainage in the fourth case. Conclusion: Reconstruction of the sella was considered necessary in only one-third of the patients who underwent operations via an endoscopic transsphenoidal procedure. Some minor expedients can be useful for the reconstruction, and the ideal material for the repair should be chosen.