Iwasa H, Miyagi K, Ishijima B, Sato F, Mizuno M
No Shinkei Geka. 1979 Jun;7(6):593-7.
Headache and visual impairment resulting from downward migration of the optic system in an acromegalic patient, occurred after one year postoperatively. A 25-year-old woman with eosinophilic adenoma was operated on via transsphenoidal approach and irradiated (5,000 rads) following the operation. After the operation, bitemporal hemianopia was thoroughly improved and serum HGH level was also markedly decreased after radiation therapy. One year later, headache and visual impairment recurred. Pneumoencephalogram revealed that the infundibular and optic recessus of the third ventricle were elongated and descended into the sella turcica. The second operation was performed by subfrontal approach and the optic system was found to be migrated into the sella, which we assumed to be the cause for the recurrence of the headache and visual field defect. In order to prevent this type of complication, it would be recommended to fill up the dead space in the sella with bone or cartilage fragments in addition to muscle pieces, as was suggested by Guiot et al.
一名肢端肥大症患者术后一年出现因视神经系统向下移位导致的头痛和视力障碍。一名25岁嗜酸性腺瘤女性患者行经蝶窦入路手术，术后接受放射治疗（5000拉德）。术后，双侧颞侧偏盲完全改善，放疗后血清生长激素水平也显著降低。一年后，头痛和视力障碍复发。气脑造影显示第三脑室漏斗和视隐窝拉长并下降至蝶鞍内。第二次手术采用额下入路，发现视神经系统移入蝶鞍，我们认为这是头痛和视野缺损复发的原因。为预防此类并发症，建议按照吉奥等的建议，除肌肉块外，用骨或软骨碎片填充蝶鞍内的死腔。
