An unusual case of post-nasal "clicking" after pituitary surgery. (November 2020)

• Record Type: Journal Article
• Authors: Tan, David Chi Hau; Robinson, Simon; Wickremesekera, Agadha
• Is Part Of: Journal of clinical neuroscience. Volume 81(2020)
• Page Start: 70
• Page End: 71
• Publication Date: 2020-11
• Subjects: Endoscopic transsphenoidal surgery -- Post-nasal clicking; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.09.013
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Novel complication of disabling post-nasal clicking after endoscopic transphenoidal removal of a pituitary tumour. Unexpected anatomy of residual cleft with pneumocephalus. Obliteration required a third endoscopic procedure. Abstract: We report a case of a 64-year-old female who represented two months after pituitary surgery with the novel complication of intermittent disabling post-nasal pulsatile "clicking". Imaging and endoscopic examination showed a residual sella cleft with the tumour capsule and diaphragma cupping against the anterior sella bony defect with each pulsation, causing the clicking. The clicking resolved following second redo surgical endoscopic repair to jail a fat graft within the residual cleft with a central barricade of conchal cartilage graft and onlay standard repair.