{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T23:33:59Z","timestamp":1768001639605,"version":"3.49.0"},"reference-count":61,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,3,11]],"date-time":"2013-03-11T00:00:00Z","timestamp":1362960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Endoscopic endonasal transplanum transtuberculum (EETT) resection of parasellar skull base (SB) tumors often results in large SB defects with intraoperative high\u2010flow cerebrospinal fluid (CSF) leaks. Reconstruction of these defects can be challenging because of the large defects size, communication with the suprasellar cistern, and close proximity to the optic nerves and chiasm. Recent studies have postulated that transplanum defects may be associated with increased postoperative CSF leakage. We review our experience with reconstruction of transplanum defects after EETT resection of parasellar SB tumors. Challenges encountered during these repairs and our operative nuances for successful reconstruction are discussed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was performed between March 2010 and February 2012 on patients undergoing reconstruction of transplanum defects after EETT resection of parasellar SB tumors. Repair materials, defect sizes, postoperative CSF leakage, postoperative CSF diversion, and demographic data were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nineteen patients who underwent 22 repairs with a pedicled nasoseptal flap (PNSF) were identified. The mean age was 47.6 years (range, 12\u201368years). Average defect size was 5.6 cm<jats:sup>2<\/jats:sup> (range, 2.2\u201310.4 cm<jats:sup>2<\/jats:sup>). Three failed repairs necessitated a revision procedure. All three revisions were successfully reconstructed with the previously used PNSF. The mean follow\u2010up period was 13.5 months (range, 1\u201326 months). The overall success rate was 86.4% for transplanum defects alone, as compared to 97.0% for our comprehensive PNSF experience in 99 repairs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Repair of large transplanum defects after EETT resection of parasellar SB tumors presents a unique challenge. Using a PNSF along with meticulous multilayer closure may help decrease postoperative CSF leaks.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.23766","type":"journal-article","created":{"date-parts":[[2013,3,13]],"date-time":"2013-03-13T08:52:56Z","timestamp":1363164776000},"page":"1353-1360","source":"Crossref","is-referenced-by-count":26,"title":["Challenges and surgical nuances in reconstruction of large planum sphenoidale tuberculum sellae defects after endoscopic endonasal resection of parasellar skull base tumors"],"prefix":"10.1002","volume":"123","author":[{"given":"Jean Anderson","family":"Eloy","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Medicine and Dentistry of New Jersey \u2013 New Jersey Medical School Newark New Jersey U.S.A."},{"name":"Department of Neurological Surgery University of Medicine and Dentistry of New Jersey \u2013 New Jersey Medical School Newark New Jersey U.S.A."},{"name":"Center for Skull Base and Pituitary Surgery Neurological Institute of New Jersey University of Medicine and Dentistry of New Jersey \u2013 New Jersey Medical School Newark New Jersey U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pratik A.","family":"Shukla","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Medicine and Dentistry of New Jersey \u2013 New Jersey Medical School Newark New Jersey U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamah J.","family":"Choudhry","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Medicine and Dentistry of New Jersey \u2013 New Jersey Medical School Newark New Jersey U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery 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