ArticlePloS one2021
Skull base reconstruction: A question of flow? A critical analysis of 521 endoscopic endonasal surgeries.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Skull base reconstruction using hydroxyapatite and nasoseptal flap versus nasoseptal flap alone: meta-analysis and systematic review.Scientific reports · 2024Pooled it
- Pedicled Nasoseptal Flap After Endoscopic Endonasal Resection of Skull Base Tumors: A Comparative Meta-Analysis with Other Modalities of Reconstruction.Journal of neurological surgery. Part B, Skull base · 2026Article
- Expert Strategies: Skull Base Reconstruction-Global Perspectives, Insights, and Algorithms through a Mixed Methods Approach.International forum of allergy & rhinology · 2025Review
- Collagen Matrix Combined With Hydroxyapatite and Nasoseptal Flap for Skull Base Reconstruction.Laryngoscope investigative otolaryngology · 2025Article
- Exploring factors behind Arginine-Vasopressine deficiency in endoscopic endonasal surgery for PitNET: a single-center analysis of 349 patients.Neurosurgical review · 2025Article
- Growth Hormone-Secreting Pituitary Adenoma: Dura Mater Invasion Is Not a Predictor of Acromegaly Persistence After Trans-Sphenoidal Surgery.Journal of clinical medicine · 2024Article
- Utility of copeptin in predicting non-pathological postoperative polyuria in patients affected by acromegaly undergoing pituitary neurosurgery.Pituitary · 2024Article
- Upright CT-based evaluation of the effects of posture on skull-base reconstruction after endoscopic endonasal surgery.Scientific reports · 2024Article
- Diaphragm reconstruction using a TachoSil patch as alternative to intrasellar packing for small focal diaphragm defects in pituitary surgery: a cohort study.Acta neurochirurgica · 2024Article
- Endoscopic endonasal odontoidectomy: a long-term follow-up results for a cohort of 21 patients.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Article
- Closure strategy for endoscopic pituitary surgery: Experience from 3015 patients.Frontiers in oncology · 2022Article
- 3D-printed guides for cervical pedicle screw placement in primary spine tumor: Case report and technical description.Frontiers in surgery · 2022Article
- Risk factors and management associated with postoperative cerebrospinal fluid leak after endoscopic endonasal surgery for pituitary adenoma.Frontiers in surgery · 2022Article
- Endoscopic resection of supergiant pituitary adenoma.Surgical neurology international · 2021Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPost-operative CSF leak still represents the main drawback of Endoscopic Endonasal Approach (EEA), and different reconstructive strategies have been proposed in order to decrease its rate.
objectiveTo critically analyze the effectiveness of different adopted reconstruction strategies in patients that underwent EEA. MATERIALS AND
methodsAdult patients with skull base tumor surgically treated with EEA were retrospectively analyzed. Data recorded for each case concerned patient demographics, type of surgical approach, histotype, anatomical site of surgical approach, intra-operative CSF leak grade (no leak (INL), low flow (ILFL), high flow (IHFL)), reconstructive adopted strategy, Lumbar Drain positioning, post-operative CSF leak rate and intra/post-operative complications.
resultsA total number of 521 patients (January 2012-December 2019) was included. Intra-operative CSF leak grade showed to be associated with post-operative CSF leak rate. In particular, the risk to observe a post-operative CSF leak was higher when IHFL was encountered (25,5%; Exp(B) 16.25). In particular, vascularized multilayered reconstruction and fat use showed to be effective in lowering post-operative CSF leaks in IHFL (p 0.02). No differences were found considering INL and ILFL groups. Yearly post-operative CSF leak rate analysis showed a significative decreasing trend.
conclusionIntra-operative CSF leak grade strongly affected post-operative CSF leak rate. Multilayer reconstruction with fat and naso-septal flap could reduce the rate of CSF leak in high risk patients. Reconstructive strategies should be tailored according also to the type and the anatomical site of the approach.
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