Cerebro-Spinal Fluid Leak in Skull Base Reconstruction Using Hadad - Bassagasteguy Flap after Endoscopic Endonasal Transsphenoidal Surgery: A Case Series

Objective: To determine the incidence of cerebrospinal fluid (CSF) leak after Hadad[1]Bassagasteguy Flap (HBF) reconstruction after endoscopic endonasal transsphenoidal surgery for skull base pathologies from 2016 to 2020 at the University of the East Ramon Magsaysay Memorial Medical Center. Methods: Design: Case Series Setting: Tertiary Private Training Hospital Participants: Charts of 35 patients who underwent endoscopic endonasal transsphenoidal surgery with reconstruction using Hadad-Bassagasteguy flap between January 2016 to February 2020 were reviewed and data on demographics, date of procedure, mass size, final diagnosis, presence of preoperative, intraoperative and postoperative CSF leak, placement of lumbar drain and course in the wards were collected. Results: There were 23 women and 12 men with ages ranging from 21 to 71 years. Four patients (11.4%) had postoperative CSF leak after reconstruction with HBF. Two of these four patients had episodes of nose blowing and sneezing weeks after surgery, prior to the development of the CSF leak. The other two patients experienced CSF leak 3 days postoperatively. Conclusion: HBF has been a workhorse for reconstruction of skull base defects after transsphenoidal surgery, and based on our experience remains to be so, making it possible for expanded approaches and a wide variety of pathologies to be operated on via the endonasal route