{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:39:37Z","timestamp":1794019177712,"version":"4.8.0"},"reference-count":54,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The endonasal transsphenoidal approach (ETA) developed over the years has become the standard of care for sellar and parasellar lesions. However, because it necessitates the removal of the skull base bone, it is often accompanied by CSF leakage. The authors aimed to provide technical nuances and analyze the results of their routine fat grafting technique after ETA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A consecutive patient cohort (2004\u20132024) of 168 patients who underwent ETA for sellar and parasellar lesions and the modified fat grafting technique for skull base repair were retrospectively reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Overall, combined ETA and transcranial approach (TCA) was performed in 7 (4.2%) patients, and 4 (2.4%) patients had prior transsphenoidal surgery. The size of the lesion was &lt; 10 mm in 24 (14.3%) patients, 10\u201330 mm in 93 (55.4%), and &gt; 30 mm in 51 (30.4%). Histopathological diagnoses were as follows: 154 (91.7%) pituitary adenomas, of which 45 (26.8%) were secreting; 8 (4.8%) Rathke\u2019s cleft cysts; 2 (1.2%) inflammatory\/autoimmune lesions; 2 (1.2%) craniopharyngiomas; 1 (0.6%) renal cell carcinoma metastasis; and 1 (0.6%) chordoma. Gross-total resection was achieved in 127 (75.6%) patients, near-total resection in 22 (13.1%), and subtotal resection\/partial resection\/biopsy in 19 (11.3%). Overall, 122 (72.6%) procedures had intraoperative CSF leakage. Postoperative CSF leakage was observed in 1 (0.6%) patient treated with a revision operation and regrafting with a slightly larger graft and lumbar drainage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Even slight modifications in contemporary surgical techniques and the addition of an innovative approach may improve the treatment of sellar and parasellar lesions via ETA and reduce the risk of CSF leakage. The authors have developed and described a modified fat grafting technique with gradual crafting and preprocessing of the abdominal fat tissue for skull base repair, and they have demonstrated its effectiveness in significantly reducing the CSF leak rate. This technique enables adequate reconstruction of skull base defects with low donor-site complication rates and obviates the need for external lumbar drainage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.11.focus24665","type":"journal-article","created":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T06:51:32Z","timestamp":1738392692000},"page":"E3","source":"Crossref","is-referenced-by-count":6,"title":["Does the crafted abdominal fat grafting technique completely eliminate risk of postoperative CSF leak in endonasal pituitary surgery? Technical note and preliminary clinical outcome"],"prefix":"10.3171","volume":"58","author":[{"given":"Nebojsa","family":"Lasica","sequence":"first","affiliation":[{"name":"Clinic of Neurosurgery, University Clinical Center of Vojvodina, Novi Sad;"},{"name":"Faculty of Medicine, University of Novi Sad, Serbia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emal","family":"Lesha","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal S.","family":"Beckfort","sequence":"additional","affiliation":[{"name":"ENT, University of Tennessee Health Science Center, Memphis; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenan I.","family":"Arnautovic","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Semmes Murphey Clinic, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Minim Invasive Neurosurg","first-page":"193","article-title":"Endoscopic endonasal transsphenoidal approach: outcome analysis of 100 consecutive procedures","volume":"45","author":"Cappabianca P","year":"2002","unstructured":"Cappabianca P, Cavallo LM, Colao A,  Endoscopic endonasal transsphenoidal approach: outcome analysis of 100 consecutive procedures. Minim Invasive Neurosurg. 2002;45(4):193\u2013200."},{"issue":"1","key":"b2","series-title":"J Neurosurg","first-page":"206","article-title":"History of endoscopic skull base surgery: its evolution and current reality","volume":"107","author":"Prevedello DM","year":"2007","unstructured":"Prevedello DM, Doglietto F, Jane JA Jr, Jagannathan J, Han J, Laws ER Jr. History of endoscopic skull base surgery: its evolution and current reality. J Neurosurg. 2007;107(1):206\u2013213."},{"issue":"6","key":"b3","series-title":"Neurosurgery","first-page":"1222","article-title":"Results of transsphenoidal surgery in a large series of patients with pituitary adenoma","volume":"56","author":"Mortini P","year":"2005","unstructured":"Mortini P, Losa M, Barzaghi R, Boari N, Giovanelli M. Results of transsphenoidal surgery in a large series of patients with pituitary adenoma. Neurosurgery. 2005;56(6):1222\u20131233."},{"issue":"2","key":"b4","series-title":"J Neurosurg","first-page":"293","article-title":"Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas","volume":"97","author":"Cappabianca P","year":"2002","unstructured":"Cappabianca P, Cavallo LM, Colao A, de Divitiis E. Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas. J Neurosurg. 2002;97(2):293\u2013298."},{"issue":"4 Suppl 2","key":"b5","series-title":"Oper Neurosurg (Hagerstown)","first-page":"295","article-title":"Graded repair of cranial base defects and cerebrospinal fluid leaks in transsphenoidal surgery","volume":"60","author":"Esposito F","year":"2007","unstructured":"Esposito F, Dusick JR, Fatemi N, Kelly DF. Graded repair of cranial base defects and cerebrospinal fluid leaks in transsphenoidal surgery. Oper Neurosurg (Hagerstown). 2007;60(4 Suppl 2):295\u2013304."},{"issue":"3","key":"b6","series-title":"Neurosurgery","first-page":"539","article-title":"Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases","volume":"55","author":"Couldwell WT","year":"2004","unstructured":"Couldwell WT, Weiss MH, Rabb C, Liu JK, Apfelbaum RI, Fukushima T. Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases. Neurosurgery. 2004;55(3):539\u2013550."},{"issue":"6","key":"b7","series-title":"Neurosurgery","first-page":"1365","article-title":"Sellar repair in endoscopic endonasal transsphenoidal surgery: results of 170 cases","volume":"51","author":"Cappabianca P","year":"2002","unstructured":"Cappabianca P, Cavallo LM, Esposito F, Valente V, De Divitiis E. Sellar repair in endoscopic endonasal transsphenoidal surgery: results of 170 cases. Neurosurgery. 2002;51(6):1365\u20131372."},{"issue":"e271","key":"b8","series-title":"World Neurosurg","first-page":"e284","article-title":"Single-layer fascia patchwork closure for the extended endoscopic transsphenoidal transtuberculum transplanum approach: deep suturing technique and preliminary results","volume":"155","author":"Tosaka M","year":"2021","unstructured":"Tosaka M, Prevedello DM, Yamaguchi R,  Single-layer fascia patchwork closure for the extended endoscopic transsphenoidal transtuberculum transplanum approach: deep suturing technique and preliminary results. World Neurosurg. 2021;155(e271):e284."},{"issue":"6","key":"b9","series-title":"Oper Neurosurg (Hagerstown)","first-page":"667","article-title":"Abdominal fat graft for sellar reconstruction: retrospective outcomes review and technical note","volume":"16","author":"Roca E","year":"2019","unstructured":"Roca E, Penn DL, Safain MG, Burke WT, Castlen JP, Laws ER. Abdominal fat graft for sellar reconstruction: retrospective outcomes review and technical note. Oper Neurosurg (Hagerstown). 2019;16(6):667\u2013674."},{"issue":"6","key":"b10","series-title":"Oper Neurosurg (Hagerstown)","first-page":"E573","article-title":"Collagen matrix with mucoperiosteum graft as an effective fatless flapless reconstruction after endoscopic pituitary adenoma resection","volume":"19","author":"Shahein M","year":"2020","unstructured":"Shahein M, Montaser AS, Barbero JMR,  Collagen matrix with mucoperiosteum graft as an effective fatless flapless reconstruction after endoscopic pituitary adenoma resection. Oper Neurosurg (Hagerstown). 2020;19(6):E573\u2013E580."},{"key":"b11","series-title":"Int J Pediatr Otorhinolaryngol","first-page":"109962","article-title":"Reconstruction of pediatric skull base defects: a retrospective analysis emphasizing the very young","volume":"133","author":"London NR Jr","year":"2020","unstructured":"London NR Jr, Rangel GG, Onwuka A,  Reconstruction of pediatric skull base defects: a retrospective analysis emphasizing the very young. Int J Pediatr Otorhinolaryngol. 2020;133109962."},{"issue":"1","key":"b12","series-title":"J Neurosurg","first-page":"161","article-title":"Novel closure technique for the endonasal transsphenoidal approach","volume":"100","author":"Liu JK","year":"2004","unstructured":"Liu JK, Orlandi RR, Apfelbaum RI, Couldwell WT. Novel closure technique for the endonasal transsphenoidal approach. J Neurosurg. 2004;100(1):161\u2013164."},{"issue":"5","key":"b13","series-title":"J Neurosurg","first-page":"1625","article-title":"Three types of dural suturing for closure of CSF leak after endoscopic transsphenoidal surgery","volume":"131","author":"Ishikawa T","year":"2018","unstructured":"Ishikawa T, Takeuchi K, Nagata Y,  Three types of dural suturing for closure of CSF leak after endoscopic transsphenoidal surgery. J Neurosurg. 2018;131(5):1625\u20131631."},{"issue":"383","key":"b14","series-title":"World Neurosurg","first-page":"391","article-title":"Endoscopic endonasal anterior skull base surgery: a systematic review of complications during the past 65 years","volume":"95","author":"Borg A","year":"2016","unstructured":"Borg A, Kirkman MA, Choi D. Endoscopic endonasal anterior skull base surgery: a systematic review of complications during the past 65 years. World Neurosurg. 2016;95(383):391."},{"issue":"2","key":"b15","series-title":"Pituitary","first-page":"174","article-title":"Endoscopic endonasal approach for pituitary adenoma: surgical complications in 301 patients","volume":"14","author":"Gondim JA","year":"2011","unstructured":"Gondim JA, Almeida JP, Albuquerque LA,  Endoscopic endonasal approach for pituitary adenoma: surgical complications in 301 patients. Pituitary. 2011;14(2):174\u2013183."},{"issue":"3","key":"b16","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Simple closure following transsphenoidal surgery","volume":"20","author":"Couldwell WT","year":"2006","unstructured":"Couldwell WT, Kan P, Weiss MH. Simple closure following transsphenoidal surgery. Neurosurg Focus. 2006;20(3):E11."},{"issue":"Suppl 1","key":"b17","series-title":"Acta Med Acad","first-page":"14","article-title":"Combined microsurgical, endoscopic and neuronavigation assisted transseptal- transsphenoidal resection of pituitary tumors","volume":"49","author":"Pojski\u0107 M","year":"2020","unstructured":"Pojski\u0107 M, Arnautovic A, Kovacevic M,  Combined microsurgical, endoscopic and neuronavigation assisted transseptal- transsphenoidal resection of pituitary tumors. Acta Med Acad. 2020;49(Suppl 1):14\u201322."},{"issue":"5","key":"b18","series-title":"World Neurosurg","first-page":"554","article-title":"The history of autologous fat graft use for prevention of cerebrospinal fluid rhinorrhea after transsphenoidal approaches","volume":"80","author":"Ziu M","year":"2013","unstructured":"Ziu M, Jimenez DF. The history of autologous fat graft use for prevention of cerebrospinal fluid rhinorrhea after transsphenoidal approaches. World Neurosurg. 2013;80(5):554\u2013562."},{"issue":"2","key":"b19","series-title":"Plast Reconstr Surg","first-page":"368","article-title":"Historical review and present status of free fat graft autotransplantation in plastic and reconstructive surgery","volume":"83","author":"Billings E Jr","year":"1989","unstructured":"Billings E Jr, May JW Jr. Historical review and present status of free fat graft autotransplantation in plastic and reconstructive surgery. Plast Reconstr Surg. 1989;83(2):368\u2013381."},{"issue":"5","key":"b20","series-title":"Arch Otolaryngol","first-page":"538","article-title":"Surgery for cerebrospinal fluid rhinorrhea and otorrhea","volume":"84","author":"Montgomery WW","year":"1966","unstructured":"Montgomery WW. Surgery for cerebrospinal fluid rhinorrhea and otorrhea. Arch Otolaryngol. 1966;84(5):538\u2013550."},{"issue":"1","key":"b21","series-title":"J Neurol Surg B Skull Base","first-page":"25","article-title":"Scarless abdominal fat graft harvest for neurosurgical procedures: technical note","volume":"76","author":"Trinh VT","year":"2015","unstructured":"Trinh VT, Duckworth EA. Scarless abdominal fat graft harvest for neurosurgical procedures: technical note. J Neurol Surg B Skull Base. 2015;76(1):25\u201328."},{"issue":"3","key":"b22","series-title":"J Neurol Surg B Skull Base","first-page":"155","article-title":"Acellular dermal allograft for sellar repair after transsphenoidal approach to pituitary adenomas","volume":"74","author":"Gaynor BG","year":"2013","unstructured":"Gaynor BG, Benveniste RJ, Lieberman S, Casiano R, Morcos JJ. Acellular dermal allograft for sellar repair after transsphenoidal approach to pituitary adenomas. J Neurol Surg B Skull Base. 2013;74(3):155\u2013159."},{"key":"b23","series-title":"Interdiscip Neurosurg","first-page":"101643","article-title":"Fat graft in cerebrospinal fluid leak repair after sellar and parasellar lesion surgery of 2000 patients; a multicenter study","volume":"30","author":"Sharifi G","year":"2022","unstructured":"Sharifi G, Bahranian A, Mohammadi E, Dilmaghani NA. Fat graft in cerebrospinal fluid leak repair after sellar and parasellar lesion surgery of 2000 patients; a multicenter study. Interdiscip Neurosurg. 2022;30:101643."},{"issue":"5","key":"b24","series-title":"J Neurol Surg B Skull Base","first-page":"522","article-title":"Surgical experience in prevention of postoperative CSF leaks using abdominal fat grafts in endoscopic endonasal transsphenoidal surgery for pituitary adenomas","volume":"82","author":"Ahn S","year":"2021","unstructured":"Ahn S, Park JS, Kim DH, Kim SW, Jeun SS. Surgical experience in prevention of postoperative CSF leaks using abdominal fat grafts in endoscopic endonasal transsphenoidal surgery for pituitary adenomas. J Neurol Surg B Skull Base. 2021;82(5):522\u2013527."},{"issue":"e590","key":"b25","series-title":"World Neurosurg","first-page":"e599","article-title":"The fate of fat graft in extended endoscopic transtuberculum-transplanum approaches","volume":"167","author":"d\u2019Avella E","year":"2022","unstructured":"d\u2019Avella E, Solari D, De Rosa A,  The fate of fat graft in extended endoscopic transtuberculum-transplanum approaches. World Neurosurg. 2022;167(e590):e599."},{"issue":"e1098","key":"b26","series-title":"World Neurosurg","first-page":"e1108","article-title":"Effectiveness of a sellar reconstruction algorithm in transsphenoidal pituitary surgery: insights from 490 cases","volume":"189","author":"Erkan B","year":"2024","unstructured":"Erkan B, Demir S, Akpinar E,  Effectiveness of a sellar reconstruction algorithm in transsphenoidal pituitary surgery: insights from 490 cases. World Neurosurg. 2024;189(e1098):e1108."},{"issue":"5-6","key":"b27","series-title":"World Neurosurg","first-page":"692","article-title":"Sequelae of autologous fat graft used for reconstruction in skull base surgery","volume":"75","author":"Taha AN","year":"2011","unstructured":"Taha AN, Almefty R, Pravdenkova S, Al-Mefty O. Sequelae of autologous fat graft used for reconstruction in skull base surgery. World Neurosurg. 2011;75(5-6):692\u2013695."},{"issue":"4","key":"b1","series-title":"Minim Invasive Neurosurg","first-page":"193","article-title":"Endoscopic endonasal transsphenoidal approach: outcome analysis of 100 consecutive procedures","volume":"45","author":"Cappabianca P","year":"2002","unstructured":"Cappabianca P, Cavallo LM, Colao A,  Endoscopic endonasal transsphenoidal approach: outcome analysis of 100 consecutive procedures. Minim Invasive Neurosurg. 2002;45(4):193\u2013200."},{"issue":"1","key":"b2","series-title":"J Neurosurg","first-page":"206","article-title":"History of endoscopic skull base surgery: its evolution and current reality","volume":"107","author":"Prevedello DM","year":"2007","unstructured":"Prevedello DM, Doglietto F, Jane JA Jr, Jagannathan J, Han J, Laws ER Jr. History of endoscopic skull base surgery: its evolution and current reality. J Neurosurg. 2007;107(1):206\u2013213."},{"issue":"6","key":"b3","series-title":"Neurosurgery","first-page":"1222","article-title":"Results of transsphenoidal surgery in a large series of patients with pituitary adenoma","volume":"56","author":"Mortini P","year":"2005","unstructured":"Mortini P, Losa M, Barzaghi R, Boari N, Giovanelli M. Results of transsphenoidal surgery in a large series of patients with pituitary adenoma. Neurosurgery. 2005;56(6):1222\u20131233."},{"issue":"2","key":"b4","series-title":"J Neurosurg","first-page":"293","article-title":"Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas","volume":"97","author":"Cappabianca P","year":"2002","unstructured":"Cappabianca P, Cavallo LM, Colao A, de Divitiis E. Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas. J Neurosurg. 2002;97(2):293\u2013298."},{"issue":"4 Suppl 2","key":"b5","series-title":"Oper Neurosurg (Hagerstown)","first-page":"295","article-title":"Graded repair of cranial base defects and cerebrospinal fluid leaks in transsphenoidal surgery","volume":"60","author":"Esposito F","year":"2007","unstructured":"Esposito F, Dusick JR, Fatemi N, Kelly DF. Graded repair of cranial base defects and cerebrospinal fluid leaks in transsphenoidal surgery. Oper Neurosurg (Hagerstown). 2007;60(4 Suppl 2):295\u2013304."},{"issue":"3","key":"b6","series-title":"Neurosurgery","first-page":"539","article-title":"Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases","volume":"55","author":"Couldwell WT","year":"2004","unstructured":"Couldwell WT, Weiss MH, Rabb C, Liu JK, Apfelbaum RI, Fukushima T. Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases. Neurosurgery. 2004;55(3):539\u2013550."},{"issue":"6","key":"b7","series-title":"Neurosurgery","first-page":"1365","article-title":"Sellar repair in endoscopic endonasal transsphenoidal surgery: results of 170 cases","volume":"51","author":"Cappabianca P","year":"2002","unstructured":"Cappabianca P, Cavallo LM, Esposito F, Valente V, De Divitiis E. Sellar repair in endoscopic endonasal transsphenoidal surgery: results of 170 cases. Neurosurgery. 2002;51(6):1365\u20131372."},{"issue":"e271","key":"b8","series-title":"World Neurosurg","first-page":"e284","article-title":"Single-layer fascia patchwork closure for the extended endoscopic transsphenoidal transtuberculum transplanum approach: deep suturing technique and preliminary results","volume":"155","author":"Tosaka M","year":"2021","unstructured":"Tosaka M, Prevedello DM, Yamaguchi R,  Single-layer fascia patchwork closure for the extended endoscopic transsphenoidal transtuberculum transplanum approach: deep suturing technique and preliminary results. World Neurosurg. 2021;155(e271):e284."},{"issue":"6","key":"b9","series-title":"Oper Neurosurg (Hagerstown)","first-page":"667","article-title":"Abdominal fat graft for sellar reconstruction: retrospective outcomes review and technical note","volume":"16","author":"Roca E","year":"2019","unstructured":"Roca E, Penn DL, Safain MG, Burke WT, Castlen JP, Laws ER. Abdominal fat graft for sellar reconstruction: retrospective outcomes review and technical note. Oper Neurosurg (Hagerstown). 2019;16(6):667\u2013674."},{"issue":"6","key":"b10","series-title":"Oper Neurosurg (Hagerstown)","first-page":"E573","article-title":"Collagen matrix with mucoperiosteum graft as an effective fatless flapless reconstruction after endoscopic pituitary adenoma resection","volume":"19","author":"Shahein M","year":"2020","unstructured":"Shahein M, Montaser AS, Barbero JMR,  Collagen matrix with mucoperiosteum graft as an effective fatless flapless reconstruction after endoscopic pituitary adenoma resection. Oper Neurosurg (Hagerstown). 2020;19(6):E573\u2013E580."},{"key":"b11","series-title":"Int J Pediatr Otorhinolaryngol","first-page":"109962","article-title":"Reconstruction of pediatric skull base defects: a retrospective analysis emphasizing the very young","volume":"133","author":"London NR Jr","year":"2020","unstructured":"London NR Jr, Rangel GG, Onwuka A,  Reconstruction of pediatric skull base defects: a retrospective analysis emphasizing the very young. Int J Pediatr Otorhinolaryngol. 2020;133109962."},{"issue":"1","key":"b12","series-title":"J Neurosurg","first-page":"161","article-title":"Novel closure technique for the endonasal transsphenoidal approach","volume":"100","author":"Liu JK","year":"2004","unstructured":"Liu JK, Orlandi RR, Apfelbaum RI, Couldwell WT. Novel closure technique for the endonasal transsphenoidal approach. J Neurosurg. 2004;100(1):161\u2013164."},{"issue":"5","key":"b13","series-title":"J Neurosurg","first-page":"1625","article-title":"Three types of dural suturing for closure of CSF leak after endoscopic transsphenoidal surgery","volume":"131","author":"Ishikawa T","year":"2018","unstructured":"Ishikawa T, Takeuchi K, Nagata Y,  Three types of dural suturing for closure of CSF leak after endoscopic transsphenoidal surgery. J Neurosurg. 2018;131(5):1625\u20131631."},{"issue":"383","key":"b14","series-title":"World Neurosurg","first-page":"391","article-title":"Endoscopic endonasal anterior skull base surgery: a systematic review of complications during the past 65 years","volume":"95","author":"Borg A","year":"2016","unstructured":"Borg A, Kirkman MA, Choi D. Endoscopic endonasal anterior skull base surgery: a systematic review of complications during the past 65 years. World Neurosurg. 2016;95(383):391."},{"issue":"2","key":"b15","series-title":"Pituitary","first-page":"174","article-title":"Endoscopic endonasal approach for pituitary adenoma: surgical complications in 301 patients","volume":"14","author":"Gondim JA","year":"2011","unstructured":"Gondim JA, Almeida JP, Albuquerque LA,  Endoscopic endonasal approach for pituitary adenoma: surgical complications in 301 patients. Pituitary. 2011;14(2):174\u2013183."},{"issue":"3","key":"b16","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Simple closure following transsphenoidal surgery","volume":"20","author":"Couldwell WT","year":"2006","unstructured":"Couldwell WT, Kan P, Weiss MH. Simple closure following transsphenoidal surgery. Neurosurg Focus. 2006;20(3):E11."},{"issue":"Suppl 1","key":"b17","series-title":"Acta Med Acad","first-page":"14","article-title":"Combined microsurgical, endoscopic and neuronavigation assisted transseptal- transsphenoidal resection of pituitary tumors","volume":"49","author":"Pojski\u0107 M","year":"2020","unstructured":"Pojski\u0107 M, Arnautovic A, Kovacevic M,  Combined microsurgical, endoscopic and neuronavigation assisted transseptal- transsphenoidal resection of pituitary tumors. Acta Med Acad. 2020;49(Suppl 1):14\u201322."},{"issue":"5","key":"b18","series-title":"World Neurosurg","first-page":"554","article-title":"The history of autologous fat graft use for prevention of cerebrospinal fluid rhinorrhea after transsphenoidal approaches","volume":"80","author":"Ziu M","year":"2013","unstructured":"Ziu M, Jimenez DF. The history of autologous fat graft use for prevention of cerebrospinal fluid rhinorrhea after transsphenoidal approaches. World Neurosurg. 2013;80(5):554\u2013562."},{"issue":"2","key":"b19","series-title":"Plast Reconstr Surg","first-page":"368","article-title":"Historical review and present status of free fat graft autotransplantation in plastic and reconstructive surgery","volume":"83","author":"Billings E Jr","year":"1989","unstructured":"Billings E Jr, May JW Jr. Historical review and present status of free fat graft autotransplantation in plastic and reconstructive surgery. Plast Reconstr Surg. 1989;83(2):368\u2013381."},{"issue":"5","key":"b20","series-title":"Arch Otolaryngol","first-page":"538","article-title":"Surgery for cerebrospinal fluid rhinorrhea and otorrhea","volume":"84","author":"Montgomery WW","year":"1966","unstructured":"Montgomery WW. Surgery for cerebrospinal fluid rhinorrhea and otorrhea. Arch Otolaryngol. 1966;84(5):538\u2013550."},{"issue":"1","key":"b21","series-title":"J Neurol Surg B Skull Base","first-page":"25","article-title":"Scarless abdominal fat graft harvest for neurosurgical procedures: technical note","volume":"76","author":"Trinh VT","year":"2015","unstructured":"Trinh VT, Duckworth EA. Scarless abdominal fat graft harvest for neurosurgical procedures: technical note. J Neurol Surg B Skull Base. 2015;76(1):25\u201328."},{"issue":"3","key":"b22","series-title":"J Neurol Surg B Skull Base","first-page":"155","article-title":"Acellular dermal allograft for sellar repair after transsphenoidal approach to pituitary adenomas","volume":"74","author":"Gaynor BG","year":"2013","unstructured":"Gaynor BG, Benveniste RJ, Lieberman S, Casiano R, Morcos JJ. Acellular dermal allograft for sellar repair after transsphenoidal approach to pituitary adenomas. J Neurol Surg B Skull Base. 2013;74(3):155\u2013159."},{"key":"b23","series-title":"Interdiscip Neurosurg","first-page":"101643","article-title":"Fat graft in cerebrospinal fluid leak repair after sellar and parasellar lesion surgery of 2000 patients; a multicenter study","volume":"30","author":"Sharifi G","year":"2022","unstructured":"Sharifi G, Bahranian A, Mohammadi E, Dilmaghani NA. Fat graft in cerebrospinal fluid leak repair after sellar and parasellar lesion surgery of 2000 patients; a multicenter study. Interdiscip Neurosurg. 2022;30:101643."},{"issue":"5","key":"b24","series-title":"J Neurol Surg B Skull Base","first-page":"522","article-title":"Surgical experience in prevention of postoperative CSF leaks using abdominal fat grafts in endoscopic endonasal transsphenoidal surgery for pituitary adenomas","volume":"82","author":"Ahn S","year":"2021","unstructured":"Ahn S, Park JS, Kim DH, Kim SW, Jeun SS. Surgical experience in prevention of postoperative CSF leaks using abdominal fat grafts in endoscopic endonasal transsphenoidal surgery for pituitary adenomas. J Neurol Surg B Skull Base. 2021;82(5):522\u2013527."},{"issue":"e590","key":"b25","series-title":"World Neurosurg","first-page":"e599","article-title":"The fate of fat graft in extended endoscopic transtuberculum-transplanum approaches","volume":"167","author":"d\u2019Avella E","year":"2022","unstructured":"d\u2019Avella E, Solari D, De Rosa A,  The fate of fat graft in extended endoscopic transtuberculum-transplanum approaches. 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