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Isolated sphenoid sinusitis or mucocele: a potential complication of endonasal transsphenoidal surgery

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Abstract

Rhinosinusitis/mucocele are rare complications of transsphenoidal surgery. We present a retrospective analysis of 323 patients who received transsphenoidal surgery for pituitary adenoma. Twenty of the 323 patients (6.2%) developed rhinosinusitis/mucocele after transsphenoidal surgery as shown by MRI. All 20 patients with rhinosinusitis/mucocele occurred in the group who received the small sphenoidotomy approach and simple postoperative nasal care. Medical management was successful in 13 of 20 cases (65%). The remaining seven patients received endoscopic sphenoidotomy. On re-operation, purulent pus was discovered in two, a necrotic fat graft in one, mucocele in one, a dropped tumor in two, and a bone chip in one. Sphenoid sinusitis resolved in all seven cases. The formation of sphenoid sinusitis/mucocele is related to the size of the sphenoidotomy, frequency of postoperative nasal care, and foreign body accumulation. Early surgical drainage is necessary in patients with rhinosinusitis/mucocele refractory to medical management to prevent ascending meningitis.

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Authors and Affiliations

  1. Department of Neurosurgery, Chang Gung Memorial Hospital, Chang Gung University Medical College, #5, Fu-Shin Street, Kwei-Shan Hsiang, Linkou, Taoyuan Hsien 333, Taiwan, ROC

    Yu-Jen Lu, Chen-Nen Chang, Kuo-Chen Wei & Chi-Cheng Chuang

  2. Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University Medical College, #5, Fu-Shin Street, Kwei-Shan Hsiang, Linkou, Taoyuan Hsien 333, Taiwan, ROC

    Ping-Ching Pai

  3. Graduate Institute of Clinical Medical Sciences, Chang Gung Memorial Hospital, Chang Gung University Medical College, #5, Fu-Shin Street, Kwei-Shan Hsiang, Linkou, Taoyuan Hsien 333, Taiwan, ROC

    Ping-Ching Pai

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  1. Yu-Jen Lu
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  2. Chen-Nen Chang
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  3. Ping-Ching Pai
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  4. Kuo-Chen Wei
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  5. Chi-Cheng Chuang
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Correspondence to Chi-Cheng Chuang.

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Yu-Jen Lu and Chen-Nen Chang have equally contributed to this article.

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Lu, YJ., Chang, CN., Pai, PC. et al. Isolated sphenoid sinusitis or mucocele: a potential complication of endonasal transsphenoidal surgery. J Neurooncol 91, 63–67 (2009). https://doi.org/10.1007/s11060-008-9681-7

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  • DOI: https://doi.org/10.1007/s11060-008-9681-7

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