Transnasal transphenoidal elevation of optic chiasm in secondary empty sella syndrome following prolactinoma treatment.

Transnasal transphenoidal elevation of optic chiasm in secondary empty sella syndrome following prolactinoma treatment.

World Neurosurg. 2018 Feb 05;:

Authors: In-Ping Huang Cobb M, Mintz-Cole R, Husain AM, Berger M, Jang D, Codd P

Abstract
BACKGROUND: Prolactinomas are typically treated non-surgically with a dopamine agonist. However, once the tumor shrinks, adjacent eloquent structures such as the optic apparatus can become skeletonized and herniate into the dilated parasellar space.
CASE DESCRIPTION: We describe here a 48-year-old man with a prolactin-secreting macroadenoma treated with cabergoline who presented with progressive bitemporal hemianopsia. MRI showed no recurrence of disease and a stretched optic chiasm herniating into an empty sella. He underwent a transnasal transphenoidal approach elevation of the optic chiasm with an alloderm graft and septal cartilage strut. He was discharged home the next day with significant improvement in his vision and an MRI showing interval elevation of the optic chiasm.
CONCLUSIONS: We review here secondary empty sella syndrome and discuss surgical strategies for optic chiasmapexy.

PMID: 29421446 [PubMed - as supplied by publisher]

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