{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T17:09:48Z","timestamp":1765040988019,"version":"3.40.5"},"reference-count":14,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T00:00:00Z","timestamp":1579478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The sellar barrier concept reflects the association between the components of the roof of the pituitary fossa and the risk of intraoperative cerebrospinal fluid (CSF) leak in the surgery of pituitary adenomas. We based our concept in previous reports on the microsurgical anatomy of the pituitary fossa's superior wall. However, proof of the usefulness of this concept in endoscopic approaches is yet missing. The aim of this study was to describe the endoscopic anatomy of the sellar barrier and its subtypes in a laboratory setting and to provide evidence of its clinical usefulness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We provided anatomical models in six fresh\u2010frozen head and neck specimens. We performed an endoscopic endonasal approach and recreated a pathological model of each possible subtype of sellar barrier. To demonstrate the usefulness of this model in clinical practice, we conducted a prospective study including all patients with pituitary adenoma operated by an endoscopic approach between June and July 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We successfully recreated the models for each subtype of sellar barrier. When analyzing the clinical cases, we found that intraoperatively, 73.69% (14) had a strong sellar barrier; 21.05% (4) had mixed sellar barrier, and 5.26% (1) had weak sellar barrier. We recorded one case of intraoperative CSF leak in a patient with a weak sellar barrier by magnetic resonance imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We described the endoscopic anatomy of the sellar barrier and we recreated the three subtypes in anatomical models. We also identified these subtypes in a series of clinical cases, proving its clinical usefulness.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ca.23566","type":"journal-article","created":{"date-parts":[[2020,1,15]],"date-time":"2020-01-15T06:40:17Z","timestamp":1579070417000},"page":"468-474","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Endoscopic anatomy of the sellar barrier: From the anatomical model to the operating room"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1544-6334","authenticated-orcid":false,"given":"Juan F.","family":"Villalonga","sequence":"first","affiliation":[{"name":"LINT, Facultad de Medicina Universidad Nacional de Tucum\u00e1n  San Miguel de Tucum\u00e1n Tucum\u00e1n Argentina"},{"name":"Division of Anatomy, Center for Anatomy and Cell Biology Medical University of Vienna  Vienna Austria"},{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery Universit\u00e0 degli Studi di Napoli Federico II  Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Fuchssteiner","sequence":"additional","affiliation":[{"name":"Division of Anatomy, Center for Anatomy and Cell Biology Medical University of Vienna  Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico","family":"Solari","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery Universit\u00e0 degli Studi di Napoli Federico II  Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvaro","family":"Campero","sequence":"additional","affiliation":[{"name":"LINT, Facultad de Medicina Universidad Nacional de Tucum\u00e1n  San Miguel de Tucum\u00e1n Tucum\u00e1n 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