To Determine Frequency of Cerebrospinal Fluid (CSF) Rhinorrohea after Trans-sphenoidal (TSS) Surgery

Introduction: Trans-sphenoidal approach has been a major technique for surgical treatment of sellar pathology since the 1960s. With the development of technical possibilities and increase in surgeons’ expertise, mortality and morbidity after such interventions have decreased. Postoperative cerebrospinal fluid (CSF) rhinorrhea, however, remains the most serious and life – threatening complication. The purpose of this study was to determine the magnitude of cerebrospinal fluid rhinorrhea after trans-sphenoidal surgery, so that proper protocols could be taken for its prevention and management in order to reduce the morbidity of these patients. Materials and Methods: A total of 116 patients, 20 to 60 years of age with sellar and supra-sellar tumours of any size were included. Patients with Rathke’s cleft cyst, meningoceles, recurrent pituitary adenomas and h/o previous surgery and radiation were excluded. All the patients had undergone trans-sphenoidal removal of the tumour and were followed after 24 hours, one week and one month post-operatively and noted for presence of any cerebrospinal fluid rhinorrhea. Results: Mean age was 45.23 ± 8.71 years in our study. Out of the 29 patients, 44.82% were male and 55.72% were females with ratio of almost 1:1. According to type of tumour, 56.90% were sellar and 43.10% were suprasellar. Cerebrospinal fluid (CSF) rhinorrhea was found in 3 (10.34%) patients, whereas there was no Cerebrospinal fluid (CSF) rhinorrhea in 26 (89.65%) patients. Conclusion: This study concluded that frequency of CSF rhinorrhea after trans-sphenoidal surgery (TSS) is 10.34% in our population. Abbreviations: CSF: Cerebrospinal Fluid. TSS: Trans-sphenoidal Surger