A new technique for clipping diaphragm defects in transsphenoidal surgery.

AIM To deal with postoperative CSF rhinorrhea, we developed a new technique using titanium/aneurysm clips to envelope the diaphragm defect to avoid postoperative CSF rhinorrhea. MATERIAL AND METHODS From January 2007 through December 2010, we used a new technique of clipping diaphragm defects to prevent CSF rhinorrhea in 57 of 510 patients (group 1) who underwent transsphenoidal surgery. The incidence of postoperative CSF rhinorrhea was compared with that of 245 patients who underwent transsphenoidal surgery before the usage of this clipping technique between January 2004 and December 2006 (group 2). RESULTS Postoperative CSF rhinorrhea developed in 8 (1.57%) patients of the 510 patients in group 1 while the new technique was used, while 17 (6.94%) patients of the 245 patients in group 2 developed CSF rhinorrhea before the usage of this technique (χ2 =14.907, P < .001). No device-related complication such as optical chiasm herniation after clipping the diaphragm defect was observed. CONCLUSION Clipping the diaphragm defect with the titanium/aneurysm clips is effective and practicable to prevent postoperative CSF rhinorrhea, it can also avoid unnecessary autologous tissue grafting and postoperative lumbar drainage.