{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:13:07Z","timestamp":1791321187753,"version":"4.3.1"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objectives\u2003Postoperative cerebrospinal fluid (Po-CSF) leak is still a challenging complication of endoscopic endonasal skull base surgery. However, data describing the predictive factors of Po-CSF leak in pure pituitary adenomas is lacking. Aim of this study is to determine the risk factors of Po-CSF leak in a pituitary adenoma group operated via pure transsellar endoscopic approach.<\/jats:p><jats:p>\n          Design\u2003This is a retrospective cohort study.<\/jats:p><jats:p>\n          Setting\u2003A single-center academic hospital.<\/jats:p><jats:p>\n          Participants\u2003Patients operated for a pituitary adenoma between 2015 and 2021 and followed up until June 2022 were included.<\/jats:p><jats:p>\n          Main Outcome Measures\u2003Demographics, comorbidities, imaging, and outcome were recorded. Univariate and multivariate logistic regression analyses were used to determine the risk factors of Po-CSF leak.<\/jats:p><jats:p>\n          Results\u2003Of the total 170 patients with a mean age of 47.5\u2009\u00b1\u200913.8 (min: 15; max: 80), 11 (6.5%) had Po-CSF leak. Univariate analysis revealed age, diabetes mellitus (DM), and tumor volume as predictors of Po-CSF leak. According to the receiver operating characteristic analysis, 7.5\u2009cm3 of tumor volume was found to be a good cutoff value with a sensitivity of 82% and a specificity of 75%. Hence, multivariable logistic regression model adjusted by age showed that a tumor volume of\u2009&gt;\u20097.5\u2009cm3 (odds ratio [OR]: 22.9; 95% confidence interval [CI]: 3.8\u2013135.9, p\u2009=\u20090.001) and DM (OR: 8.9; 95% CI: 1.7\u201346.5; p\u2009=\u20090.010) are strong independent risk factors of Po-CSF leak in pure endoscopic endonasal pituitary surgery.<\/jats:p><jats:p>\n          Conclusion\u2003Besides younger age and DM, a cutoff value for tumor volume\u2009&gt;\u20097.5\u2009cm3 is the most remarkable risk factor for Po-CSF leak in pure endoscopic pituitary surgery. These patients should carefully be assessed preoperatively and potential preemptive surgical strategies should be taken into consideration to avoid complications.<\/jats:p>","DOI":"10.1055\/a-2065-6377","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T23:54:11Z","timestamp":1680134051000},"page":"318-324","source":"Crossref","is-referenced-by-count":5,"title":["The Predictors of Postoperative Cerebrospinal Fluid Leak in Endoscopic Endonasal Pituitary Surgery: The Role of Tumor Volume"],"prefix":"10.1055","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1008-9171","authenticated-orcid":false,"given":"Nuri Eralp","family":"Cetinalp","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cukurova University Faculty of Medicine, Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozg\u00fcr","family":"Tarkan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Cukurova University Faculty of Medicine, Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gamze","family":"Akku\u015f","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Cukurova University Faculty of Medicine, Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerem Mazhar","family":"Ozsoy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cukurova University Faculty of Medicine, Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dogu Cihan","family":"Yildirim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cukurova University Faculty of Medicine, Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulsah","family":"Seydaoglu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Cukurova University Faculty of Medicine, Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kadir","family":"Oktay","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cukurova University Faculty of Medicine, Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahsin","family":"Erman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cukurova University Faculty of Medicine, Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"iii1","DOI":"10.1093\/neuonc\/noab200","article-title":"CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2014-2018","volume":"23","author":"Q T Ostrom","year":"2021","journal-title":"Neuro-oncol"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1007\/s11102-017-0839-1","article-title":"Preoperative risk factors for postoperative complications in endoscopic pituitary surgery: a systematic review","volume":"21","author":"D J Lobatto","year":"2018","journal-title":"Pituitary"},{"issue":"08","key":"ref3","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1161\/01.STR.27.8.1304","article-title":"The ABCs of measuring intracerebral hemorrhage volumes","volume":"27","author":"R U Kothari","year":"1996","journal-title":"Stroke"},{"issue":"04","key":"ref4","first-page":"610","article-title":"Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings","volume":"33","author":"E Knosp","year":"1993","journal-title":"Neurosurgery"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.wneu.2017.01.119","article-title":"Risk factors and management of intraoperative cerebrospinal fluid leaks in endoscopic treatment of pituitary adenoma: analysis of 492 patients","volume":"101","author":"Q Zhou","year":"2017","journal-title":"World Neurosurg"},{"issue":"S 01","key":"ref6","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.2337\/dc22-S002","article-title":"2. 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