J Neurol Surg A Cent Eur Neurosurg 2016; 77(03): 229-232
DOI: 10.1055/s-0035-1547357
Original Article
Georg Thieme Verlag KG Stuttgart · New York

A Sandwich Technique for Prevention of Cerebrospinal Fluid Rhinorrhea and Reconstruction of the Sellar Floor after Microsurgical Transsphenoidal Pituitary Surgery

Christian F. Freyschlag
1   Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria
Stephanie Alice Goerke
1   Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria
Jochen Obernauer
1   Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria
Johannes Kerschbaumer
1   Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria
Claudius Thomé
1   Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria
Marcel Seiz
2   Department of Neurosurgery, University Medical Center Mannheim, Mannheim, Germany
› Author Affiliations
Further Information

Publication History

05 August 2013

30 December 2014

Publication Date:
19 June 2015 (online)


Background Cerebrospinal fluid (CSF) leaks are a well-known complication of transsphenoidal surgery. Several autologous and artificial grafts have been used to close the sellar floor in an attempt to prevent postoperative CSF rhinorrhea.

Objective To evaluate and describe a sandwich technique to close the sellar floor using autologous bone, absorbable gelatin sponge, and coated collagen fleece.

Methods We reviewed 50 consecutive patients between April 2010 and August 2011 who underwent transsphenoidal surgery ending with reconstruction of the sellar floor with a particular sandwich technique. Patients with an intraoperative CSF leak received an additional lumbar drain.

Results There were no cases of CSF rhinorrhea at postoperative follow-up after 6 weeks and no revision surgery.

Conclusion The proposed sandwich technique for closure of the sellar floor to the sphenoid sinus is a suitable alternative to autologous grafts and seems to be effective in preventing CSF rhinorrhea.

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