{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T14:26:22Z","timestamp":1791642382313,"version":"4.3.4"},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T00:00:00Z","timestamp":1471910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009734","name":"Olympus","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009734","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004328","name":"Genentech","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004328","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In patients undergoing transnasal endoscopic sellar surgery, an analysis of risk factors and predictors of intraoperative and postoperative cerebrospinal fluid leak (CSF) would provide important prognostic information.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of patients undergoing endoscopic sellar surgery for pituitary adenomas or craniopharyngiomas between 2002 and 2014 at 7 international centers was performed. Demographic, comorbidity, and tumor characteristics were evaluated to determine the associations between intraoperative and postoperative CSF leaks. Correlations between reconstructive and CSF diversion techniques were associated with postoperative CSF leak rates. Odds ratios (OR) were identified using a multivariate logistic regression model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data were collected on 1108 pituitary adenomas and 53 craniopharyngiomas. Overall, 30.1% of patients had an intraoperative leak and 5.9% had a postoperative leak. Preoperative factors associated with increased intraoperative leaks were mild liver disease, craniopharyngioma, and extension into the anterior cranial fossa. In patients with intraoperative CSF leaks, postoperative leaks occurred in 10.3%, with a higher postoperative leak rate in craniopharyngiomas (20.8% vs 5.1% in pituitary adenomas). Once an intraoperative leak occurred, craniopharyngioma (OR = 4.255, <jats:italic>p<\/jats:italic> = 0.010) and higher body mass index (BMI) predicted postoperative leak (OR = 1.055, <jats:italic>p<\/jats:italic> = 0.010). In patients with an intraoperative leak, the use of septal flaps reduced the occurrence of postoperative leak (OR = 0.431, <jats:italic>p<\/jats:italic> = 0.027). Rigid reconstruction and CSF diversion techniques did not impact postoperative leak rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intraoperative CSF leaks can occur during endoscopic sellar surgery, especially in larger tumors or craniopharyngiomas. Once an intraoperative leak occurs, risk factors for postoperative leaks include craniopharyngiomas and higher BMI. Use of septal flaps decreases this risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21783","type":"journal-article","created":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T13:46:47Z","timestamp":1471960007000},"page":"1117-1125","source":"Crossref","is-referenced-by-count":92,"title":["Factors impacting cerebrospinal fluid leak rates in endoscopic sellar surgery"],"prefix":"10.1002","volume":"6","author":[{"given":"Tom T.","family":"Karnezis","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew B.","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary M.","family":"Soler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah K.","family":"Wise","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Emory University  Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruthi K.","family":"Rereddy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Emory University  Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zara M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Emory University  Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson M.","family":"Oyesiku","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Emory University  Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"DelGaudio","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Emory University  Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantinos G.","family":"Hadjipanayis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Emory University  Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradford A.","family":"Woodworth","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head &amp; Neck Surgery University of Alabama at Birmingham  Birmingham AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen O.","family":"Riley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Alabama at Birmingham  Birmingham AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery, University of Toronto St. Michael's Hospital  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Cusimano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, St. Michael's Hospital University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Govindaraj","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Mount Sinai Hospital  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkis","family":"Psaltis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Royal Adelaide Hospital  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter John","family":"Wormald","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Royal Adelaide Hospital  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Santoreneos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Royal Adelaide Hospital  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Sindwani","sequence":"additional","affiliation":[{"name":"Section of Rhinology, Head and Neck Institute Cleveland Clinic  Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Trosman","sequence":"additional","affiliation":[{"name":"Section of Rhinology, Head and Neck Institute Cleveland Clinic  Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janalee K.","family":"Stokken","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Mayo Clinic  Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy D.","family":"Woodard","sequence":"additional","affiliation":[{"name":"Section of Rhinology, Head and Neck Institute Cleveland Clinic  Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo F.","family":"Recinos","sequence":"additional","affiliation":[{"name":"Section of Rhinology, Head and Neck Institute Cleveland Clinic  Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"W. Alexander","family":"Vandergrift","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney J.","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,8,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2012.06.024"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.85.4.1420"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-011-0540-6"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1998.89.4.0547"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2014.07.023"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318170b5dc"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3171\/2011.1.FOCUS10308"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.10.JNS09406"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000325862.83961.12"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000095534"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e328334db5b"},{"key":"e_1_2_6_13_1","first-page":"e1","article-title":"A technique for endoscopic pituitary removal","volume":"1","author":"Cusimano MD","year":"1996","journal-title":"J Neurosurg"},{"key":"e_1_2_6_14_1","first-page":"343","article-title":"Endoscopic endonasal transphenoidal surgery: experience with 50 patients","volume":"47","author":"Jho HD","year":"1997","journal-title":"J Neurosurg"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22475"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2014.08.009"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2011.06.018"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.11.JNS121190"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3171\/2013.6.JNS122259"}],"container-title":["International Forum of Allergy &amp; Rhinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Falr.21783","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.21783","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T06:38:48Z","timestamp":1696574328000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/alr.21783"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,23]]},"references-count":18,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2016,11]]}},"alternative-id":["10.1002\/alr.21783"],"URL":"https:\/\/doi.org\/10.1002\/alr.21783","archive":["Portico"],"relation":{},"ISSN":["2042-6976","2042-6984"],"issn-type":[{"value":"2042-6976","type":"print"},{"value":"2042-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8,23]]}}}