C. Darrigo et Am. Landolt, FIBRIN SEALING OF MUCOPERICHONDRIAL FLAPS IN ENDONASAL-TRANSSPHENOIDAL PITUITARY SURGERY - TECHNICAL NOTE, Neurosurgery, 35(3), 1994, pp. 529-531
DESCRIBE A simple technique that helps to avoid nasal septum perforati
ons and the related complications after endonasal-transseptal transsph
enoidal pituitary surgery. At the end of the Hirsch procedure, the muc
operichondrium is fixed to the septal cartilage with a thin layer of f
ibrin glue. Two silicone splints are applied to both sides of the sept
um and left in place for 2 days. The technique is very useful in preve
nting possible displacement of the mucoperichondrium, which may lead t
o compression and ischemia of the doubled mucosa between the septal ca
rtilage and the silicone splints. A firm fixing of the margins of a mu
copepichondrial laceration to the septal cartilage creates conditions
for optimal healing and reduces nasal-packing time and nasal-splinting
time. The technique is recommended for all patients with and without
mucosal tears and is also recommended for the transsphenoidal reoperat
ions.