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Old 12-19-2010, 07:56 PM   #1
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CSF leak post transphenoidal surgery to remove pituitary macroadenoma?

Hi, I had endoscopic transphenoidal surgery performed to remove a pituitary macro-adenoma on 11/29/10. The surgeons (ENT and Neuro) say the surgery went very well and they did not see or suspect a CSF leak. I had a LOT of bloody discharge after the surgery for close to two weeks, which the surgeons assured me was normal. Headaches went away a week after surgery but resumed, along with nose pain, after I started to sneeze about two weeks after surgery. I'm now almost three weeks out and sneeze (cannot stop it, no matter how much I try) 2-3 times a day. This causes pain in my nose, a slight headache, which tylenol relieves, and I continue to have nasal discharge but now it's not bloody, it's clear. There's no post nasal drip, no salty or metallic aftertaste, the headaches are infrequent, I feel fine standing up and lying down, and the discharge is not constant but has me worried. I saw my ENT a week after surgery and he wasn't concerned. I will see him in three days again (three weeks post surgery). I think I just caught a cold - hence the sneezing, but I wanted to get others' thoughts as well. What do you think?

For those of you who had surgery through the nose, what was your recovery like? Did you have discharge? If so, for how long?

Thank you!
Lana

 
Old 12-20-2010, 05:09 AM   #2
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Re: CSF leak post transphenoidal surgery to remove pituitary macroadenoma?

Hi Lana

I was diagnosed in 2002 with Acromegaly (pituitary adenoma) and underwent surgery through my nose. The following day I noticed a discharged from my nose. The neuro-surgeon suspected a CSF leak. I went into theatre again and it was then determined that the brain membrane was damaged during the first operation thus causing the leak. The tear was attended to during a 6 hour operation. I was hospitalized for 14 days with tubes up my spine to drain the fluid. For the first year after this I was not allowed to blow my nose where I closed one or both nostrils. I had to do it with both nostrils opened. I had to sneeze without any obstruction of the airways. Glad to say that I have had no side affects or the problem did not occur again. Only side affect from the surgery through my nose is that I now suffers from sinusitis.

Good luck.

 
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Old 12-20-2010, 05:16 AM   #3
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Re: CSF leak post transphenoidal surgery to remove pituitary macroadenoma?

Hi, Dirkus. I'm sorry you hadto go through two surgeries back to back like that but am so glad you are okay now. Why did the neur suspect a csf leak and not attribute it to normal dscharge post transsphenoidal surgery? What kind of discharge did u have?

Thanks,
Svetlana

 
Old 12-20-2010, 05:43 AM   #4
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Re: CSF leak post transphenoidal surgery to remove pituitary macroadenoma?

Hi Svetlana

The neuro first thought it to be normal discharge post transsphenoidal and scheduled a lumber. But, as he battled to get the tube up my spine, and because of the absolute pain, he scheduled to do the lumber under local anaesthetic to spare me the pain. Once in theatre, as the removed the plugs from my nose the CSF leak worsened. The ENT was called and via a camera it was determined that the brain membrane was damaged with the first operation as the tumor was prior to the operation already 15 mm in dia with a 20 mm in dia cist. The tumor was attached to the membrane.

regards

 
Old 12-20-2010, 05:57 AM   #5
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Re: CSF leak post transphenoidal surgery to remove pituitary macroadenoma?

Wow! Sounds like u had a great neuro who took action quickly. It also sounds like, based on the size and position of your tumor, he had real reason to suspect and be cocnerned about CSF.

My situation may be a little different, as both my ENT and neuro were confident I would Not have a leak. I just cannot seem to explain the discharge...

 
Old 02-15-2011, 12:31 AM   #6
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Re: CSF leak post transphenoidal surgery to remove pituitary macroadenoma?

Hi

I had a Macroadenoma removed on the 10th of Jan, I felt fine after the op but the next day there was leaking in my left nostril. A sample was taken and immediately diagnosed as a CSF leak... I had a 2nd op on the 16th and it was repaired.

I was back at work within a week from this and my nose is still incredibly sore and I sound like I have bad cold...

I do find I sneeze a lot but I can blow my nose and it seems be going well.

Hope that you are recovering as well from your ops

 
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