ABSTRACT
Background: Endoscopic endonasal sellar reconstructions (EER) were associated with leaks of cerebrospinal fluid (CSF) after pituitary surgery. Collagen matrix dural substitutes are used for watertight dura closure. Objectives: to assess the effectiveness and safety of collagen matrix dural substitute in compare with autograft for EER.
Patients and Methods: A retrospective randomized comparative clinical review of 24 patients underwent (EER) after pituitary surgery with intraoperative CSF leaks. 24 EER patients between (17 – 55) years were included. And classified into 2 groups (A and B), each group 12 patients. Group A (Collagen matrix dural substitute) and group B (fascia lata). Followed up for at least 3 months, the primary outcome was success rate (representing efficacy), while the secondary outcomes were repair failure rate, and complications rate (representing safety).
Results: 19 patients (79.2%) had successful EER, 9 group A patients, and 10 group B patients. Only 5 patients (20.8%) had repair failure and need recurrent sellar reconstruction with vascularized septal flap, 3 (25%) from group A, and 2 (16.6%) from group B. No perioperative mortalities. 3 patients (12.5%) had pneumocephalus, 1 group A patient, and 2 group B patients. 4 patients (16.7%) had postoperative headache, 3 patients from group A, and 1 from group B. No substantial statistical difference between the 2 groups regarding efficacy and safety data, (p > 0.05 respectively).
Conclusion: Collagen matrix dural substitute is an efficient and safe material and the initial findings were similar to autograft.