Nasogastric Tube Feeding into Brain After Endoscopic Endonasal Transsphenoidal Surgery

World Neurosurg. 2019 Dec:132:4-6. doi: 10.1016/j.wneu.2019.08.040. Epub 2019 Aug 14.

Abstract

The endoscopic endonasal transsphenoidal (EET) approach for skull base tumors has become increasingly popular. We know that bone defects in the skull base can cause cerebrospinal fluid rhinorrhea, but for patients who need to be intubated through the nose, the tube can enter the brain through a skull base bone defect. Nasogastric tube feeding into the brain is a rare occurrence, and this situation can occur only in the case of a skull base defect. We treated a patient with an unusual complication after the EET approach for pituitary adenoma resection. This particular case suggests that bone defects after EET surgery can not only cause cerebrospinal fluid rhinorrhea but also allow the entry of a nasogastric tube into the brain. For patients with a history of EET surgery, endoscopy-assisted gastric tube implantation can be performed if necessary.

Keywords: Complications; Endoscopic endonasal transsphenoidal approach; Nasogastric tube; Pituitary adenoma.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / surgery*
  • Aged
  • Brain Contusion / diagnostic imaging
  • Brain Contusion / etiology*
  • Computed Tomography Angiography
  • Enteral Nutrition
  • Female
  • Humans
  • Intubation, Gastrointestinal / adverse effects*
  • Nasal Cavity
  • Neuroendoscopy
  • Pituitary Neoplasms / surgery*
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology*
  • Skull Base / surgery*
  • Tomography, X-Ray Computed