Ishihara Eriko, Toda Masahiro, Sasao Ryota, Ozawa Hiroyuki, Saito Shin, Ogawa Kaoru, Yoshida Kazunari
Department of Neurosurgery, Keio University School of Medicine, Sinjuku-ku, Tokyo, Japan.
Department of Neurosurgery, Keio University School of Medicine, Sinjuku-ku, Tokyo, Japan.
World Neurosurg. 2019 Jan;121:145-148. doi: 10.1016/j.wneu.2018.10.012. Epub 2018 Oct 11.
Visual field deterioration caused by secondary empty sella after cabergoline therapy for prolactinoma is a rare event. Chiasmapexy is performed to treat empty sella syndrome. Although various materials have been used for the elevation of the optic chasm, the most appropriate material remains to be established. Here, we describe the efficiency of chiasmapexy for empty sella syndrome following dopamine agonist treatment and the utility of septal cartilage and sphenoidal sinus bone as materials for chiasmapexy.
A 35-year-old male with a history of cabergoline therapy for prolactinoma presented with visual deterioration. His magnetic resonance imaging revealed optic chiasm herniation into the empty sella. Endoscopic endonasal transsphenoidal chiasmapexy was performed using septal cartilage and sphenoidal sinus bone as materials for elevating the chiasm. Visual function improved immediately after operation.
Chiasmapexy is an effective surgical method for treating visual deterioration caused by empty sella after cabergoline treatment. Endoscopic endonasal chiasmapexy with septal cartilage and sphenoidal sinus bone is a considerable option because it is minimally invasive and involves decreased risk of infection.
卡麦角林治疗泌乳素瘤后继发空蝶鞍导致的视野恶化是一种罕见事件。视神经交叉固定术用于治疗空蝶鞍综合征。尽管已使用多种材料来抬高视交叉，但最合适的材料仍有待确定。在此，我们描述多巴胺激动剂治疗后视神经交叉固定术对空蝶鞍综合征的疗效以及鼻中隔软骨和蝶窦骨作为视神经交叉固定术材料的效用。
一名有卡麦角林治疗泌乳素瘤病史的35岁男性出现视力恶化。他的磁共振成像显示视交叉疝入空蝶鞍。采用鼻中隔软骨和蝶窦骨作为抬高视交叉的材料，进行了内镜下经鼻蝶窦视神经交叉固定术。术后视力功能立即改善。
视神经交叉固定术是治疗卡麦角林治疗后空蝶鞍引起的视力恶化的有效手术方法。采用鼻中隔软骨和蝶窦骨的内镜下经鼻蝶窦视神经交叉固定术是一个相当不错的选择，因为它微创且感染风险降低。
