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

Dejan Slavnic; Richard Cook; Matthew Bahoura; Gijong Paik; Doris Tong; Clifford Houseman; Ryan Barrett; Teck-Mun Soo

doi:10.4103/ajns.AJNS_130_18

Asian Journal of Neurosurgery, Inhaltsverzeichnis

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

¹Department of Surgery, Providence-Providence Park Hospitals, College of Human Medicine, Michigan State University, East Lansing, Southfield, Michigan

,

Richard Cook

¹Department of Surgery, Providence-Providence Park Hospitals, College of Human Medicine, Michigan State University, East Lansing, Southfield, Michigan

,

Matthew Bahoura

²Michigan Spine and Brain Surgeons, Providence-Providence Park Hospitals, Southfield, Michigan

,

Gijong Paik

²Michigan Spine and Brain Surgeons, Providence-Providence Park Hospitals, Southfield, Michigan

,

Doris Tong

¹Department of Surgery, Providence-Providence Park Hospitals, College of Human Medicine, Michigan State University, East Lansing, Southfield, Michigan

²Michigan Spine and Brain Surgeons, Providence-Providence Park Hospitals, Southfield, Michigan

,

Clifford Houseman

¹Department of Surgery, Providence-Providence Park Hospitals, College of Human Medicine, Michigan State University, East Lansing, Southfield, Michigan

²Michigan Spine and Brain Surgeons, Providence-Providence Park Hospitals, Southfield, Michigan

,

Ryan Barrett

¹Department of Surgery, Providence-Providence Park Hospitals, College of Human Medicine, Michigan State University, East Lansing, Southfield, Michigan

²Michigan Spine and Brain Surgeons, Providence-Providence Park Hospitals, Southfield, Michigan

,

Teck-Mun Soo

¹Department of Surgery, Providence-Providence Park Hospitals, College of Human Medicine, Michigan State University, East Lansing, Southfield, Michigan

²Michigan Spine and Brain Surgeons, Providence-Providence Park Hospitals, Southfield, Michigan

› Institutsangaben

Abstract

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

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Referenzen

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