Abstract
Background:
Empty sella syndrome (ESS) is a condition in which there is loss of volume of the pituitary gland, which is the normal constituent of the sella turcica. There may be visual and endocrine deficits associated with this condition, and radiologically, there may be downward prolapse of the optic chiasm. It occurs in a primary ESS, poorly understood form, as well as a secondary ESS form that follows medical or surgical treatment of a pituitary macroadenoma, or else spontaneous hemorrhage into such a tumor.
Case Description:
A 56-year-old man presenting with deficits of both visual acuity and visual fields in the setting of radiological ESS without associated optic chiasm prolapse is discussed. He underwent endoscopic endonasal chiasmapexy with gradual improvement of his visual function over the following 6 months.
Conclusion:
ESS is a potentially potent cause of visual deterioration that lends itself to reversal through a relatively simple neurosurgical technique. This case illustrates that actual prolapse of the chiasm is neither a prerequisite for visual deterioration nor its reversal the mechanism of visual improvement after chiasmapexy, raising the question of the mechanisms at play in cases such as this. It confirms the role of chiasmapexy in the management of selected cases of ESS.
Subject
Neurology (clinical),Surgery
Reference10 articles.
1. Primary empty sella syndrome presenting with severe hyponatremia and minimal salt wasting;Aijazi;J Ayub Med Coll Abbottabad,2016
2. Primary empty sella syndrome and the prevalence of hormonal dysregulation;Auer;Dtsch Arztebl Int,2018
3. Treatment of empty sella associated with visual impairment: A systematic review of chiasmapexy techniques;Barzaghi;Pituitary,2018
4. Diagnosis of endocrine disease: Primary empty sella: A comprehensive review;Chiloiro;Eur J Endocrinol,2017
5. Transnasal transsphenoidal elevation of optic chiasm in secondary empty sella syndrome following prolactinoma treatment;Cobb;World Neurosurg,2018
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献