NoSeal Trial: Comparing Sealants Versus No Sealant for Preventing CSF Leak After Endonasal Skull Base Surgery

This study (the NoSeal Trial) is comparing two surgical techniques after minimally invasive brain surgery through the nose (called endonasal skull base surgery): using a tissue sealant to prevent cerebrospinal fluid (CSF) leaks versus not using one. This type of surgery is typically done to remove pituitary tumors or other skull base lesions. **You may be eligible if...** - You are 18 or older and are scheduled for endonasal (through-the-nose) skull base surgery with standard reconstruction - Your blood pressure and electrolytes are stable before surgery **You may NOT be eligible if...** - You are having revision (repeat) surgery or a complex reconstruction procedure - You have pre-existing hydrocephalus (fluid build-up in the brain) - You have a known allergy to the sealant materials - You have an active sinus infection or systemic inflammatory disease - You have had prior radiation to the pituitary/skull base area - Your blood sugar is poorly controlled (HbA1c above 7.0%) - You are participating in another trial that may affect healing Talk to your doctor to see if this trial is right for you.