Easy Sellar Reconstruction in Endoscopic Endonasal Transsphenoidal Surgery with Polyester-Silicone Dural Substitute and Fibrin Glue: Technical Note

OBJECTIVE To describe a simple method of sellar reconstruction after endoscopic endonasal transsphenoidal surgery that will allow rapid watertight closure of the sellar floor. METHODS A bent sheet of a polyester-silicone dural substitute, fashioned for this purpose with scissors, is introduced into the sella after removal of the lesion. Because of the consistency of the sheet, it opens spontaneously and becomes stuck. Autologous fat tissue or gelatin foam is positioned thereafter, followed by another layer of the dural substitute; a film of fibrin glue completes the sealing. RESULTS Fifteen patients underwent this method and no postoperative cerebrospinal leak or other complication was experienced. CONCLUSION This easy method of sellar reconstruction represents an effective and fast possibility to perform the final step of the endoscopic transsphenoidal procedure, which otherwise may cause maneuverability problems in the limited space of one nostril.