Clinical evaluation of the sellar mass patient

Sellar masses are common and encompass various pathologies, many of which are treated surgically via the transsphenoidal route. Postoperative cerebrospinal fluid (CSF) leaks are a significant complication of this approach and are associated with increased morbidity and costs. Therefore, anticipating an intraoperative CSF leak and understanding risk factors for a postoperative CSF leak are essential in surgical planning. Intraoperative and postoperative CSF leaks in patients with sellar masses are multifactorial. They include patient-specific factors, lesion characteristics, surgical strategy, reconstruction techniques, and perioperative interventions. This chapter focuses on the preoperative evaluation of patients with sellar masses with particular attention to considerations for intra- and postoperative CSF leaks.