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Transsphenoidal chiasmapexy for correction of posthypophysectomy traction syndrome of optic chiasm: Case report

Published on Apr 1, 1977in Journal of Neurosurgery
· DOI :10.3171/jns.1977.46.4.0527
Robert E. Decker9
Estimated H-index: 9
,
Robert Carras11
Estimated H-index: 11
Cite
Abstract
✓ Postoperative improvement occurred as a result of transsphenoidal chiasmapexy in a patient with posthypophysectomy visual loss. Traction injury of the optic chiasm may have been caused by a deficient diaphragma sellae and inadequate packing and repair of the sella floor. A cartilaginous seal is recommended.
  • References (7)
  • Citations (20)
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References7
Newest
Published on Jun 1, 1975in Surgical Neurology
Wood Jg1
Estimated H-index: 1
,
Dogali M1
Estimated H-index: 1
22 Citations
Published on Jan 1, 1974in Neurosurgery 4.61
William F. Collins17
Estimated H-index: 17
22 Citations Source Cite
Published on Nov 1, 1972in Journal of Neurosurgery
Donald R. Olson1
Estimated H-index: 1
,
Gerard Guiot7
Estimated H-index: 7
,
Patrick Derome12
Estimated H-index: 12
✓ Visual difficulty in association with an empty sella, resulting from downward migration of the optic system and secondary stretching or kinking of the optic nerves, is presented as a surgical entity best managed by the transsphenoidal approach. Pertinent case reports with characteristic pneumoencephalograms and schematic drawings are used to develop this thesis.
65 Citations Source Cite
Published on Dec 1, 1971in Journal of Neurosurgery
Keasley Welch23
Estimated H-index: 23
,
John C. Stears12
Estimated H-index: 12
✓ A patient recovered full vision after evacuation of a chromaphobe adenoma and subsequent irradiation, but experienced delayed visual loss in the left eye associated with descent of the diaphragm of the sella and the optic nerves and chiasm into the tumor bed. More normal anatomical relationships were restored by inserting silicone sponge beneath the diaphragm of the sella. Vision improved rapidly thereafter and has been maintained for more than 3½ years.
46 Citations Source Cite
Published on Jan 1, 1971in Radiology 7.61
Thomas P. Hayes2
Estimated H-index: 2
,
Richard A. Davis1
Estimated H-index: 1
,
Antolin Raventos3
Estimated H-index: 3
Abstract The authors review the treatment of chromophobe adenomas at the Hospital of the University of Pennsylvania from 1950 through 1967. Only 6% of the early group received postoperative radiotherapy, whereas 46% of the later group were treated in this manner. In each period, one-third received irradiation alone. As in several other published series, the results of irradiation alone and planned postoperative radiation therapy were the same. Radiation therapy alone is recommended for the initi...
40 Citations Source Cite
Published on May 1, 1970in Journal of Neurosurgery
Richard H. Mortara7
Estimated H-index: 7
(UK: University of Kentucky),
Horace Norrell18
Estimated H-index: 18
(UK: University of Kentucky)
n EPORTS concerning the "empty sella turclca s " . ~ " yndrome have produced confusing as well as conflicting hypotheses as to the etiology of this entity. Busch's 6 anatomical description of the incomplete sellar diaphragm and Kaufman's 24 explanation of the physiological mechanisms producing the "empty" sella have done much to clarify this condition. The purpose of this paper is to further elaborate this entity and to discuss the consequences that many occur as a result of an incomplete or abs...
87 Citations Source Cite
Cited By20
Newest
Published on Feb 1, 2018in Pituitary 3.33
Lina Raffaella Barzaghi5
Estimated H-index: 5
(UniSR: Vita-Salute San Raffaele University),
Carmine Antonio Donofrio4
Estimated H-index: 4
(UniSR: Vita-Salute San Raffaele University)
+ 2 AuthorsPietro Mortini27
Estimated H-index: 27
(UniSR: Vita-Salute San Raffaele University)
Purpose Chiasmapexy is a poorly described surgical procedure adopted to correct the downward displacement of suprasellar visual system (SVS) into an empty sella (ES) causing visual worsening. The aim of our study is to define the indications for extradural and intradural chiasmapexy.
2 Citations Source Cite
Published on Feb 1, 2018in World Neurosurgery 1.72
Mary In-Ping Huang Cobb4
Estimated H-index: 4
(Duke University),
Matthew G. Crowson7
Estimated H-index: 7
(Duke University)
+ 4 AuthorsPatrick J. Codd11
Estimated H-index: 11
(Duke University)
Background Prolactinomas are typically treated nonsurgically with a dopamine agonist. Once the tumor shrinks, adjacent eloquent structures, such as the optic apparatus, can become skeletonized and herniate into the dilated parasellar space. Case Description A 48-year-old man with a prolactin-secreting macroadenoma treated with cabergoline presented with progressive bitemporal hemianopsia. Magnetic resonance imaging showed no recurrence of disease and a stretched optic chiasm herniating into an e...
2 Citations Source Cite
Published on Nov 1, 2017in World Neurosurgery 1.72
Atsushi Tsukiyama1
Estimated H-index: 1
(Nippon Medical School),
Yujiro Hattori3
Estimated H-index: 3
(Nippon Medical School)
+ 5 AuthorsAkio Morita41
Estimated H-index: 41
(Nippon Medical School)
Background Chiasmapexy is used to treat empty sella syndrome, and various materials are used for the elevation of the optic chiasm. However, the use of artificial substances may have the risk of graft infection, and fat and muscle may be absorbed over the long term after surgery. In addition, bone and cartilage may be unavailable in adequate amounts. Here, we describe a new technique for chiasmapexy using an iliac crest bone graft. Case Description The first patient was a 71-year-old woman who h...
1 Citations Source Cite
Published on Apr 1, 2016in Journal of Neurosurgery
G. Rene Alvarez Berastegui1
Estimated H-index: 1
,
Shaan Mohammed Raza17
Estimated H-index: 17
+ 1 AuthorsTheodore H. Schwartz56
Estimated H-index: 56
(Cornell University)
Visual deterioration after dopamine-agonist treatment of prolactinomas associated with empty sella syndrome and secondary optic apparatus traction is a rare event. Chiasmapexy has been described as a viable treatment option, although few cases exist in the literature. Here, a novel endonasal endoscopic approach to chiasmapexy is described and its efficacy is demonstrated in a case report. A 55-year-old female patient with a history of a giant prolactinoma and 14 years of treatment using dopamine...
5 Citations Source Cite
Published on Aug 1, 2015in World Neurosurgery 1.72
Brandon D. Liebelt9
Estimated H-index: 9
(Houston Methodist Hospital),
Meng Huang3
Estimated H-index: 3
(Houston Methodist Hospital),
David S. Baskin32
Estimated H-index: 32
(Houston Methodist Hospital)
Objective The Medpor porous polyethylene implant provides benefits to perform sellar floor reconstruction when indicated. This material has been used for cranioplasty and reconstruction of skull base defects and facial fractures. We present the most extensive use of this implant for sellar floor reconstruction and document the safety and benefits provided by this unique implant. Methods The medical charts for 200 consecutive patients undergoing endonasal transsphenoidal surgery from April 2008 t...
9 Citations Source Cite
Published on Apr 1, 2014in Hormones (Greece)
Labrini Papanastasiou6
Estimated H-index: 6
,
Stelios Fountoulakis7
Estimated H-index: 7
+ 4 AuthorsGeorge Piaditis14
Estimated H-index: 14
OBJECTIVE Dopamine agonists (DA) are the treatment of choice in patients with macroprolactinomas. Brain and optic chiasm herniation are unusual complications following treatment with DA.
2 Citations Source Cite
Published on Aug 1, 2011in Neuro-Ophthalmology
Akshay Gopinathan Nair7
Estimated H-index: 7
(SN: Sankara Nethralaya),
Shikha Bassi1
Estimated H-index: 1
(SN: Sankara Nethralaya)
+ 2 AuthorsK. R. Suresh Bapu
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...
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Published on Jan 1, 2008in Gaceta Medica De Mexico 0.28
Gerardo Guinto-Balanzar4
Estimated H-index: 4
,
Moisés Mercado-Atri2
Estimated H-index: 2
+ 4 AuthorsBárbara Nettel Rueda1
Estimated H-index: 1
SUMMARY Background: The empty sella is an entity that only rarely presents signs and symptoms. When noted, visual field deficits are an indication for surgical management. Material and methods: We studied twenty patients with primary empty sella and visual field deficits surgically treated with a technique termed by us as “sellar remodeling.” We treated 19 females and 1 male. Aside from visual deficits, all participants reported headache. We reported an increase in prolactin serum level in three...
Published on Jun 1, 2007in Contemporary neurosurgery
Gerardo Guinto11
Estimated H-index: 11
,
Moisés Mercado24
Estimated H-index: 24
+ 3 AuthorsBarbara Nettel4
Estimated H-index: 4
4 Citations Source Cite