Skull Base 2011; 21(3): 189-192
DOI: 10.1055/s-0031-1275632
ORIGINAL ARTICLE

© Thieme Medical Publishers

Use of Hemostatic Matrix for Hemostasis of the Cavernous Sinus during Endoscopic Endonasal Pituitary and Suprasellar Tumor Surgery

Anupama D. Bedi1 , Steven A. Toms1 , Amir R. Dehdashti1 , 2
  • 1Department of Neurosurgery, Geisinger Medical Center, Danville
  • 2Temple University School of Medicine, Philadelphia, Pennsylvania
Further Information

Publication History

Publication Date:
24 March 2011 (online)

ABSTRACT

The endoscopic endonasal approach offers a wide, panoramic exposure of the sellar floor, planum, and clivus. The ability to expose fully the tumor margins, through lateral extension of cavernous sinuses, increases the exposure and ability to resect the tumor but increases the risk of bleeding. The authors describe achieving hemostasis using a hemostatic matrix, FloSeal (Baxter Biosciences, Vienna, Austria) sealant, during endoscopic endonasal tumor removal, specifically for pituitary and suprasellar tumors. Thirty-nine cases (33 pituitary adenomas, 4 craniopharyngiomas, 1 clival plasmacytoma, and 1 planum meningioma) are described using this technique. FloSeal was injected directly to the site of bleeding, and a cottonoid was used for further tamponade, immediately achieving hemostasis with no hemorrhagic complications in any of the patients. Surgery could be immediately pursued without any delay. This simple nuance can be used as a safe method in cavernous sinus hemostasis during endoscopic endonasal surgery and may decrease operative time.

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Anupama D BediP.A.-C. 

Department of Neurosurgery, Geisinger Medical Center, 100 N. Academy Avenue

M.C. 14-05, Danville, PA 17821

Email: abedi1@geisinger.edu