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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(02): 607-611
DOI: 10.4103/ajns.AJNS_130_18
Case Series

Bone morphogenetic protein in the repair of cerebrospinal fluid leak after transsphenoidal surgery

Dejan Slavnic
1   Department of Surgery, Providence-Providence Park Hospitals, College of Human Medicine, Michigan State University, East Lansing, Southfield, Michigan
,
Richard Cook
1   Department of Surgery, Providence-Providence Park Hospitals, College of Human Medicine, Michigan State University, East Lansing, Southfield, Michigan
,
Matthew Bahoura
2   Michigan Spine and Brain Surgeons, Providence-Providence Park Hospitals, Southfield, Michigan
,
Gijong Paik
2   Michigan Spine and Brain Surgeons, Providence-Providence Park Hospitals, Southfield, Michigan
,
Doris Tong
1   Department of Surgery, Providence-Providence Park Hospitals, College of Human Medicine, Michigan State University, East Lansing, Southfield, Michigan
2   Michigan Spine and Brain Surgeons, Providence-Providence Park Hospitals, Southfield, Michigan
,
Clifford Houseman
1   Department of Surgery, Providence-Providence Park Hospitals, College of Human Medicine, Michigan State University, East Lansing, Southfield, Michigan
2   Michigan Spine and Brain Surgeons, Providence-Providence Park Hospitals, Southfield, Michigan
,
Ryan Barrett
1   Department of Surgery, Providence-Providence Park Hospitals, College of Human Medicine, Michigan State University, East Lansing, Southfield, Michigan
2   Michigan Spine and Brain Surgeons, Providence-Providence Park Hospitals, Southfield, Michigan
,
Teck-Mun Soo
1   Department of Surgery, Providence-Providence Park Hospitals, College of Human Medicine, Michigan State University, East Lansing, Southfield, Michigan
2   Michigan Spine and Brain Surgeons, Providence-Providence Park Hospitals, Southfield, Michigan
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Background: Recurrent cerebrospinal fluid (CSF) leak carries significant morbidity. We sought to demonstrate that bone morphogenetic protein (BMP) use is effective and safe for the repair of recurrent CSF leak after a transsphenoidal pituitary tumor resection (TSPTR). Materials and Methods: We reviewed charts and radiographic data of consecutive patients who underwent BMP repair of recurrent CSF leak after TSPTR from January 2010 to June 2015 and who failed previous multilayer closure. We detailed the technique for constructing and placing a BMP-DuraGen patch for the repair. The primary variables include postoperative computed tomography/magnetic resonance imaging (CT/MRI) evidence of ectopic bone growth or inflammation, newly diagnosed systemic neoplasm within 1 year, and recurrent CSF leak. Secondary outcome is the length of stay after BMP repair. All patients were followed up radiographically and through phone interview. Results: Four patients underwent BMP repair of recurrent CSF leak after TSPTR. The average postoperative CT/MRI interval was 22 months. Postoperative CT/MRI revealed no ectopic bone formation or inflammatory changes around the site of BMP application. There was no recurrence of CSF leak or newly diagnosed neoplasm from both chart review and phone interview. Conclusions: We demonstrate that the use of BMP is a safe and an effective treatment in the repair of recurrent CSF leaks after TSPTR.

Key-words:

Bone morphogenetic protein - recurrent cerebrospinal fluid leak - pituitary - transsphenoidal

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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