Transsphenoidal Treatment of Empty Sella by Means of a Silastic Coil: Technical Note

Zona, Gianluigi; Testa, Valeria; Sbaffi, Pier Filippo; Spaziante, Renato

doi:10.1227/01.neu.0000061090.07104.ae

Cited by 5 publications

(10 citation statements)

References 2 publications

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“…It is generally agreed that in patients with progressive visual deterioration surgery is warranted, and should consist of chiasmapexy [1] or sellar packing. A wide variety of materials has been used for this purpose, including muscle, fat, fragments of cartilage or bone, bioabsorbable materials, dural substitutes, silastic coils [4,5] and infl ated balloons [6] . Sellar packing has both the risk of insuffi cient packing due to retraction of the packing over time, and overpacking with compression on the optic chiasm and worsening visual outcome [5,7] .…”

Section: Transsphenoidal Treatment Of Secondary Empty Sella Syndrome mentioning

confidence: 99%

Transsphenoidal Treatment of Secondary Empty Sella Syndrome using Low Field Strength Intraoperative MRI: Case Report

Kubben

Cornips²,

Looij³

et al. 2010

Minim Invasive Neurosurg

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Section: Transsphenoidal Treatment Of Secondary Empty Sella Syndrome mentioning

confidence: 99%

Transsphenoidal Treatment of Secondary Empty Sella Syndrome using Low Field Strength Intraoperative MRI: Case Report

Kubben

Cornips²,

Looij³

et al. 2010

Minim Invasive Neurosurg

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“…In 2002 Zona et al published a report in which they described a novel surgical technique applied for empty sella syndrome surgery. For dura mater elevation they applied a spirally coiled section of the intraventricular drain from a valve kit (silastic coil) [14]. A similar effect was obtained by Kubo et al using silicone plates [15].…”

Section: Introductionmentioning

confidence: 78%

“…The application of silicone material for reconstruction of the sella in transspheniodal procedures is not novel [19,20]. Its use in the form of a silicone spiral for sella and chiasm elevation in the empty sella turcica syndrome has been described by Zona et al [14]. Sutured silastic plates have been used for a similar purpose by Kubo et al [15].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Transsphenoidal Treatment of Empty Sella Turcica Syndrome Using a Silastic Coil

Rudnik¹,

Zawadzki²,

Gałuszka-Ignasiak³

et al. 2006

Minim Invasive Neurosurg

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An empty sella turcica is due to the presence of an arachnoid diverticulum with its fluid content in the sella turcica, exerting pressure on the pituitary gland. In most cases this condition has an asymptomatic course, and is discovered by accident. Some patients, however, develop empty sella turcica syndrome with headaches, mild dishormonose, dysopsia and, rarely, spontaneous rhinorrhoea. Surgical treatment of empty sella turcica consists of filling the sella, through the transsphenoid route, with tissues collected from the patient or with artificial material. The aim of this report is to present our own experience of endoscopic extradural sella elevation using a silicone spiral, in 4 patients with primary empty sella turcica syndrome. The main indication for surgery was progressing dysopsia. The microinvasive endoscopic transsphenoidal method has been used, based upon the Jho technique with our own modifications. For the elevation of the sella, we used a coiled section of a Pudenz valve intraventricular silicone drain, adjusting its size to the dimensions of the operated sella. Both the implantation of the helix, and the postoperative course were uncomplicated for all surgically treated patients. The follow-up of several months confirmed improvement of the dysopsia in all surgically treated patients. MR examinations confirmed the correct location of the silicone spiral placed in the sella. It seems that the good results achieved are due to a correct indication for surgical treatment. The follow-up period ranges from 12 to 30 months and, so far, the clinical improvement is stable and satisfying both for the patients who underwent treatment and for the neurosurgeons.

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“…10 Landolt also mentions in his commentary of a technical note by Zona et al on transsphenoidal treatment of empty sella by means of a silastic coil that he found no correlation between the surgical result (improvement, no change or a slow deterioration) and any radiological or clinical factor that would allow a prediction of the final outcome or a selection of patients who might experience a benefit from the intervention. 16 Landolt also mentions that the surgically induced change in the chiasmal contour could have a beneficial effect by altering the cerebrospinal fluid flow; this, however, has not been unequivocally demonstrated.…”

Section: Neuro-ophthalmologymentioning

confidence: 99%

“…Chiasmapexy involving extradural packing has also been achieved by using a Silastic (Dow Corning, Auburn, MI) coil, fashioned by means of a ventricular catheter arranged as a spiral. 16 Silastic, being inert, has a lower risk of post-operative shrinkage, and is not associated with inflammatory complications and owing to its elasticity, it does not cause excessive compression of sellar, parasellar, or suprasellar structures. 16 Sekhar and Oliveira also have described a case of a 53-year-old woman who presented with diminution of vision in both eyes 2 years after a transsphenoidal resection of a large pituitary tumour.…”

Section: Neuro-ophthalmologymentioning

confidence: 99%

What Comes Down Must Go Up—Chiasmal Prolapse: A Field Report

Nair

Noronha

Moodambikana³

et al. 2011

Neuro-Ophthalmology

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We report a case of a 45-year-old man who had experienced considerable improvement in vision following surgery to excise a non-functioning pituitary adenoma. However, 1 year after surgery, during a regular followup, secondary visual field changes were detected that prompted neuroimaging. Magnetic resonance imaging revealed an empty sella with chiasmal prolapse, with no recurrence of the tumour. The patient underwent an endoscopic endonasal transsphenoidal chiasmapexy. Post-operatively the visual fields and the visual acuity showed improvement. This case emphasises the need for monitoring of visual fields, even post-operatively in cases of pituitary tumour. Chiasmal herniation can cause secondary visual field changes, early recognition of which can help in prompt surgical intervention to reverse the field loss.

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Transsphenoidal Treatment of Empty Sella by Means of a Silastic Coil: Technical Note

Cited by 5 publications

References 2 publications

Transsphenoidal Treatment of Secondary Empty Sella Syndrome using Low Field Strength Intraoperative MRI: Case Report

Transsphenoidal Treatment of Secondary Empty Sella Syndrome using Low Field Strength Intraoperative MRI: Case Report

Endoscopic Transsphenoidal Treatment of Empty Sella Turcica Syndrome Using a Silastic Coil

What Comes Down Must Go Up—Chiasmal Prolapse: A Field Report

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