Utilizing In-Situ Bone Flap for Skull Base Reconstruction in Endoscopic Surgery of Invasive Pituitary Adenoma: A Novel Approach

Abstract Objective: To evaluate the efficacy of in-situ bone flap (ISBF) repositioning technique in skull base reconstruction for invasive pituitary adenoma (IPA) via endoscopic endonasal approach (EEA). Method: In a retrospective study spanning the years 2018 to 2023, we investigated the efficacy of in-situ bone flap (ISBF) repositioning technique in patients with invasive pituitary adenoma (IPA) who underwent endoscopic endonasal surgery (EEA). Among the 115 patients included in the study, 65 were assigned to the group, while the remaining 55 were categorized into the non-ISBF group. Comprehensive data on patients’ basic characteristics, surgical situation, and clinical outcomes were meticulously collected and analyzed. Results: In our study, we observed postoperative cerebrospinal fluid (CSF) leakage in 1 out of 65 patients in the ISBF group, while 8 out of 50 patients in the non-ISBF group experienced this complication, indicating a significant difference (P<0.05). Conclusion: The ISBF repositioning technique emerges as an effective and feasible method for skull base reconstruction in patients who have underwent EEA surgery for IPA. Notably, this technique significantly reduces the incidence of postoperative CSF leakage.