Reconstruction strategies for intraoperative CSF leak in endoscopic endonasal surgery for pituitary adenomas: A narrative review

Repair techniques in pituitary adenoma surgery are critical for preventing postoperative complications such as cerebrospinal fluid (CSF) leaks and meningitis. Despite their importance, significant controversy, and heterogeneity exist regarding the steps involved in repair, the materials employed, and the indications for various techniques. Definitions, classification schemes, and practices vary widely, adding to the complexity of standardizing these procedures. A thorough literature review was conducted to summarize the current repair techniques used in endoscopic pituitary adenoma surgery. This review focuses on factors affecting post-op CSF leaks, the indications for different repair methods, the materials utilized, and their reported outcomes. Additionally, we address the discrepancies in existing studies and highlight the controversies surrounding optimal repair strategies. Our findings provide a summary of evidence-based recommendations to guide the selection of tailored repair techniques, ensuring optimal outcomes for each patient.