A Special Focus on the Role of Continuous Lumbar Drain in Managing Post-Operative CSF Leakage Following Endoscopic Endonasal Surgeries: Retrospective Study

Background: With the wide use of Endoscopy; endonasal approach for pituitary surgery it is now considered as the gold standard approach to sellar lesions. Been considered as a safe and effective approach for pituitary tumor resection in many series; however, there’s no surgery without risks or potential complications CSF leak is One of the most common and is one of the main causes of morbidity like meningitis and pneumo-cephalus. Aim of Study: To study the effect of continous lumber drain in treating post-operative CSF leak. Patients and Methods: 133 patients all presenting with a pituitary adenoma who underwent endoscopic endonasal trans-spheroidal approach, 21 of them suffered from post oper-ative CSF leakage for more than 24 hours for whom a 18-gauge catheter was introduced into the subarachnoid space between L3 and L4 under local anesthesia. Results: 21 patients experienced arachnoid tear and CSF leak for more than 24 hours post operatively, while all other patients were excluded; leak was incident in 15.7% of the cases (21 of 133). 15 patients improved on conservative measures. With no recurrence after removal of the drainage. 6 patients (28.5%) continued to have CSF leak on day 5 postoperatively who required endoscopic endo nasal repair. Conclusion: Lumbar drains are commonly used foremost operative CSF diversion as a prophylactic measure and/or as first-line treatment for CSF rhinorrhea following trans-sphe-roidal approach of hypophysectomy. The risk of complication is low with the use of lumbar drain; however, it increases the length of hospitalization.