Reconstruction of Skull Base Defects in Pituitary Surgery

Advancements in sellar floor defect reconstruction have expanded the capacity of skull base surgery complexity. Several investigators have developed grading scales for the intraoperative appearance of the sella following pituitary tumor resection. Certain repairs are unnecessary for lower-grade defects that typically involve low-flow cerebrospinal fluid (CSF) leaks and do not require complex repair techniques. Higher-grade defects that result in high-flow CSF leaks may require more advanced techniques, such as the nasoseptal flap or a combination of repair techniques. This review summarizes the current strategies for repair of the sella following pituitary tumor resection.