Easy sellar reconstruction in endoscopic endonasal transsphenoidal surgerywith polyester-silicone dural substitute and fibrin glue: Technical note

OBJECTIVE: To describe a simple method of sellar reconstruction after endos copic endonasal transsphenoidal surgery that will allow rapid watertight cl osure of the sellar floor. METHODS: A bent sheet of a polyester-silicone dural substitute, fashioned f or this purpose with scissors, is introduced into the sella after removal o f the lesion. Because of the consistency of the sheet, it opens spontaneous ly and becomes stuck. Autologous fat tissue or gelatin foam is positioned t hereafter, followed by another layer of the dural substitute; a film of fib rin glue completes the sealing. RESULTS: Fifteen patients underwent this method and no postoperative cerebr ospinal leak or other complication was experienced. CONCLUSION: This easy method of sellar reconstruction represents an effecti ve and fast possibility to perform the final step of the endoscopic transsp henoidal procedure, which otherwise may cause maneuverability problems in t he limited space of one nostril.