Which action after transsphenoidal hypophysectomy would be a priority to monitor to prevent CSF leak?

• A. Eating spicy foods
• B. Ambulating without assistance
• C. Wearing a nasal packing
• D. Drinking fluids through a straw

Answer: (D)

After this surgery, protecting the surgical repair in the skull base is crucial, so actions that create negative pressure in the nasal passages or increase intracranial pressure should be avoided. Drinking through a straw can generate suction in the nasopharynx, which can pull on the repair and promote a CSF leak. Spicy foods don’t directly affect the leak, ambulating without assistance isn’t related to the CSF path of repair, and nasal packing is used to help seal the site. So, avoiding straws is the priority to prevent CSF leakage and protect the outcome. Signs of a CSF leak would include clear nasal drainage that may have a salty taste and may be accompanied by headache; reporting these promptly is important.