{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:36:33Z","timestamp":1790620593976,"version":"4.1.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T00:00:00Z","timestamp":1662508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82103048, 82072804, 82071559"],"award-info":[{"award-number":["82103048, 82072804, 82071559"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine risk factors and management for the development of a postoperative cerebrospinal fluid (CSF) leak after an endoscopic endonasal surgery (EES) for pituitary adenomas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The clinical data of 400 patients who underwent EES for resection of pituitary adenomas from December 2018 to November 2019 in the Department of Neurosurgery of Beijing Tiantan Hospital were retrospectively reviewed. Age, gender, body mass index (BMI), tumor size, Knosp grade, suprasellar extension grade, sellar floor erosion grade, repeated transsphenoidal surgery, intraoperative CSF leak, use of pedicled nasoseptal flap and lumbar drain were collected and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Postoperative CSF leak occurred in 14 of 400 patients (3.5%). Age, gender, BMI, tumor size, Knosp grade and repeated transsphenoidal surgery were not risk factors for CSF leak. Suprasellar extension grade (\u2265B 6.0% vs. &amp;lt;B 1.4%; <jats:italic>p<\/jats:italic>\u2009=\u20090.024), sellar floor erosion grade (\u2265III 5.7% vs. &amp;lt;III 0.6%; <jats:italic>p<\/jats:italic>\u2009=\u20090.020) and intraoperative CSF leak (Yes 7.5% vs. No 2.0%; <jats:italic>p<\/jats:italic>\u2009=\u20090.009) were factors associated with an increased postoperative CSF leak rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Higher suprasellar extension grade, higher sellar floor erosion grade and intraoperative CSF leak were risk factors for postoperative CSF leak after endoscopic treatment of pituitary adenoma. Strict skull base reconstruction including use of a pedicled nasoseptal flap and perioperative lumbar drainage may avoid postoperative CSF leak.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.973834","type":"journal-article","created":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T05:52:20Z","timestamp":1662529940000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":19,"title":["Risk factors and management associated with postoperative cerebrospinal fluid leak after endoscopic endonasal surgery for pituitary adenoma"],"prefix":"10.3389","volume":"9","author":[{"given":"Bin","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sida","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuyue","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding","family":"Nie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haibo","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuzhong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songbai","family":"Gui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazhuo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"10214","DOI":"10.1158\/0008-5472.CAN-05-0884","article-title":"Novel molecular signaling and classification of human clinically nonfunctional pituitary adenomas identified by gene expression profiling and proteomic analyses","volume":"65","author":"Moreno","year":"2005","journal-title":"Cancer Res"},{"key":"B2","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.wneu.2012.06.024","article-title":"Pituitary tumor surgery: review of 3004 cases","volume":"79","author":"Loyo-Varela","year":"2013","journal-title":"World Neurosurg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1055\/s-0039-1679896","article-title":"Predictive factors, 30-day clinical outcomes, and costs associated with cerebrospinal fluid leak in pituitary adenoma resection","volume":"81","author":"Parikh","year":"2020","journal-title":"J Neurol Surg Part B"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.3171\/2016.12.JNS1694","article-title":"Risk factors associated with postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery","volume":"128","author":"Fraser","year":"2018","journal-title":"J Neurosurg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.3171\/2012.2.JNS111837","article-title":"Elevated body mass index and risk of postoperative CSF leak following transsphenoidal surgery","volume":"116","author":"Dlouhy","year":"2012","journal-title":"J Neurosurg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1172","DOI":"10.3171\/2018.4.JNS172447","article-title":"Does lumbar drainage reduce postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery? 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