Factors Affecting Porous High-Density Polyethylene Implant Exposure in Patients Undergoing Endoscopic Transsphenoidal Resection of Sellar Lesions

Objective: The purpose of this study was to determine which patient characteristics are associated with exposure of porous high-density polyethylene (PHDPE) used in transsphenoidal resection (TSR) of sellar lesions.

Design: A retrospective chart review was performed.

Patients: The study included patients undergoing TSR from July 2004–December 2010 for whom complete records were available, including PHDPE exposure, demographics, tumor type, presence of otolaryngologist at surgery, comorbidities, and radiographic data.

Setting: We conducted the study at an academic tertiary care center.

Outcome Measures: Exposure of PHDPE on follow-up examination was reviewed.

Results: A total of 174 patients were included; 19 (10.9%) had exposure of the Porex graft. There was no statistically significant correlation of graft exposure to any of the patient data analyzed. Although not statistically significant, when the Otolaryngology service was involved in the procedure, 8/51 (15.68%) developed Porex graft exposure compared with 11/123 (8.94%) when not involved.

Conclusions: There is no reliable predictor of which patients will develop Porex graft exposure following TSR of sellar lesions. Patients with abnormal anatomy, previous sinus surgery, or other paranasal sinus conditions prompting the involvement of an otolaryngologist may be at higher risk for developing graft exposure. All patients should undergo routine evaluation for Porex exposure.