• Gerardo Guinto, Barbara Nettel, Eli Hernández, David Gallardo, Norma Aréchiga, and Moisés Mercado.
• Skull Base Program, Universidad Nacional Autónoma de México, Mexico City, Mexico; Centro Neurológico ABC, Mexico City, Mexico. Electronic address: gguinto@prodigy.net.mx.
• World Neurosurg. 2019 Jun 1; 126: e953-e958.

BackgroundEmpty sella is an anatomic finding that is usually asymptomatic. However, when patients with empty sella finding present with visual deficits, surgical treatment may be necessary. The main goal of surgery is to elevate sellar content through a transsphenoidal approach. The aim of this study was to demonstrate a new technique for precise reconstruction of the sellar floor using a heterologous bone block to restore the anatomic elements of the sella turcica.MethodsThree patients with primary empty sella who presented with visual field defects were prospectively included. Surgery was performed through a microsurgical transsphenoidal approach and involved elevating the sellar content by using a tricortical heterologous bone graft, the dimensions of which were obtained considering the exact dimensions of each patient's sella turcica. The graft was premodeled outside the surgical bed and carefully introduced into the sella turcica to achieve the required elevation (chiasmapexy).ResultsVision of all 3 patients improved, and the improvement persisted throughout the follow-up period. 2 patients, this improvement was noted immediately after surgery, and in the third patient, this change in vision occurred 1 week later. Long-term imaging studies showed the persistence of the bone graft in the sella turcica and the exact elevation of the sellar content at the end of the follow-up period. There were no complications in the present series.ConclusionsThe technique presented here is simple and reproducible and allows an almost exact and persistent elevation of the sellar content.Copyright © 2019 Elsevier Inc. All rights reserved.

4 keywords...

hide…