SynthesisPituitary2021
Skull base repair following endonasal pituitary and skull base tumour resection: a systematic review.
Synthesis in Pituitary, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Porous polyethylene implant for skull base reconstruction in transsphenoidal surgery: a systematic literature review and institutional case series.Neurosurgical review · 2026Pooled it
- Sphenoid Sinus Mucosal Flap after Transsphenoidal Surgery-A Systematic Review.Medicina (Kaunas, Lithuania) · 2024Pooled it
- A Novel BERT-Based Machine Learning Approach for Enhanced CSF Leak Prediction in Endoscopic Endonasal Skull Base Surgery.Journal of neurological surgery. Part B, Skull base · 2026Article
- Bioengineered Materials for Skull Base Reconstruction-Current Clinical Applications: Systematic Review and Meta-analysis.Journal of neurological surgery. Part B, Skull base · 2026Article
- Tailored Postoperative Reconstruction for Low-Grade Cerebrospinal Fluid Leaks in Pituitary Neuroendocrine Tumors.Journal of Korean Neurosurgical Society · 2026Article
- Skull Base Reconstruction Following Endoscopic Pituitary Surgery: A Global Survey.Journal of neurological surgery. Part B, Skull base · 2026Article
- Skull base reconstruction strategy for high-flow CSF leaks during EEA surgery based on the quality of pedicled nasoseptal flap.Scientific reports · 2026Article
- Dural Closure Method Using Dural Suture and Polyglycolic Acid Nonwoven Fabric in the Endoscopic Endonasal Approach.Journal of neurological surgery. Part B, Skull base · 2026Article
- A triple-layer, autograft-free reconstruction strategy for skull base repair after standard endoscopic endonasal resection of pituitary adenomas.Frontiers in surgery · 2026Article
- Expert Strategies: Skull Base Reconstruction-Global Perspectives, Insights, and Algorithms through a Mixed Methods Approach.International forum of allergy & rhinology · 2025Review
- Postoperative Management Following Endoscopic Skull Base Reconstruction: A Multidisciplinary Cross-Sectional Survey.Head & neck · 2025Article
- Utilization of Polydioxanone Plate for Endoscopic Anterior Skull Base Repair: Operative Technique and Long-Term Cohort Outcomes.Journal of neurological surgery. Part B, Skull base · 2025Article
- Sphenoid sinus hyperpneumatization: anatomical variants, molecular blueprints, and AI-augmented roadmaps for skull base surgery.Frontiers in endocrinology · 2025Review
- Modified salpingopharyngeus myomucosal flap: a novel technique for skull base reconstruction.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Article
- Endoscopic and exoscopic surgery for brain tumors.International journal of clinical oncology · 2024Review
- Skull Base Repair following Resection of Vestibular Schwannoma: A Systematic Review (Part 2: The Translabyrinthine Approach).Journal of neurological surgery. Part B, Skull base · 2024Article
- Skull Base Repair following Resection of Vestibular Schwannoma: A Systematic Review (Part 1: The Retrosigmoid Approach).Journal of neurological surgery. Part B, Skull base · 2024Article
- The Incidence of Radiologic Evidence of Sinusitis Following Endoscopic Pituitary Surgery: A Multi-Center Study.Journal of clinical medicine · 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
- A Comprehensive Analysis of Tobacco Smoking History as a Risk for Outcomes after Endoscopic Transsphenoidal Resection of Pituitary Adenoma.Journal of neurological surgery. Part B, Skull base · 2024Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
purposePostoperative cerebrospinal fluid rhinorrhoea (CSFR) remains a frequent complication of endonasal approaches to pituitary and skull base tumours. Watertight skull base reconstruction is important in preventing CSFR. We sought to systematically review the current literature of available skull base repair techniques.
methodsPubmed and Embase databases were searched for studies (2000-2020) that (a) reported on the endonasal resection of pituitary and skull base tumours, (b) focussed on skull base repair techniques and/or postoperative CSFR risk factors, and (c) included CSFR data. Roles, advantages and disadvantages of each repair method were detailed. Random-effects meta-analyses were performed where possible.
results193 studies were included. Repair methods were categorised based on function and anatomical level. There was absolute heterogeneity in repair methods used, with no independent studies sharing the same repair protocol. Techniques most commonly used for low CSFR risk cases were fat grafts, fascia lata grafts and synthetic grafts. For cases with higher CSFR risk, multilayer regimes were utilized with vascularized flaps, gasket sealing and lumbar drains. Lumbar drain use for high CSFR risk cases was supported by a randomised study (Oxford CEBM: Grade B recommendation), but otherwise there was limited high-level evidence. Pooled CSFR incidence by approach was 3.7% (CI 3-4.5%) for transsphenoidal, 9% (CI 7.2-11.3%) for expanded endonasal, and 5.3% (CI 3.4-7%) for studies describing both. Further meaningful meta-analyses of repair methods were not performed due to significant repair protocol heterogeneity.
conclusionsModern reconstructive protocols are heterogeneous and there is limited evidence to suggest the optimal repair technique after pituitary and skull base tumour resection. Further studies are needed to guide practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.