P.036 Securing the nasoseptal flap in endoscopic transsphenoidal surgery: no Foley catheter needed!
Bibliographic record
Abstract
Background: The nasoseptal flap, commonly used in endoscopic transsphenoidal surgical, is typically held in position for several days post-operatively by a nasal Foley catheter balloon. The purpose of this study is to describe our experience with an alternative technique to buttress the nasoseptal flap that renders the use of a Foley catheter unnecessary. Methods: A review of our Halifax Neuropituitary Program’s database identified patients who underwent endoscopic transsphenoidal surgery for a pituitary macroadenoma with nasoseptal flap, secured with small rolls of GelfoamTM rather than a nasal Foley catheter. Minimum follow-up clinical and MRI assessments: 3 months. Results: 69 patients (mean follow-up: 22 months) met the inclusion criteria: 53 non-functioning and 16 functioning pituitary adenomas. 36 patients had an intraoperative CSF leak: 29 high flow and 7 low flow leaks. 35 patients were repaired by a fat +/- fascia graft. One patient had a post-operative CSF leak repaired by subsequent surgery without the use of a Foley catheter. Conclusions: In our experience, 1 of the 69 (1.4%) patients required post-operative CSF leak repair, well within the incidence of 1 to 3% reported in the literature. Securing the nasoseptal flap can be achieved without the use of a nasal Foley catheter.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".