LINT, Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina; Department of Neurological Surgery, Hospital Padilla, Tucumán, Argentina.
Laboratory of Microsurgical Neuroanatomy, Second Chair of Gross Anatomy, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina; Department of Neurological Surgery, Hospital San Fernando, Buenos Aires, Argentina.
World Neurosurg. 2021 Mar;147:66. doi: 10.1016/j.wneu.2020.12.065. Epub 2021 Jan 6.
Sellar arachnoidocele is a term used to define the herniation of the subarachnoid space to the sella. This is a rare radiologic finding that, in most cases, does not require treatment. When symptoms appear, the term empty sella syndrome is used. Two varieties exist: primary and secondary empty sella syndrome. The aim of this 3-dimensional operative video (Video 1) is to demonstrate the extradural microsurgical remodeling of the sellar fossa with autologous bone in 2 cases of primary empty sella syndrome. Both patients signed an informed consent for the procedures and agree with the use of their images for research purposes. In both cases, magnetic resonance imaging scans showed herniation of the subarachnoid space into the pituitary fossa and an anchor-like silhouette on coronal view. Patients evolved favorably, improving their visual deficit after the surgery, as can be observed in the postoperative visual field study. If surgery is indicated due to visual loss, the procedure is known as chiasmapexy. Recently, Guinto et al described a technique for chiasmapexy. Our team considers this procedure to be useful, technically simple, and low cost. Being autologous, rejection possibilities are almost null. This 3D video serves as a complement to illustrate the technique.
鞍内蛛网膜囊肿是一个用于定义蛛网膜下腔向鞍内疝出的术语。这是一种罕见的影像学发现，在大多数情况下不需要治疗。当出现症状时，使用空蝶鞍综合征这一术语。空蝶鞍综合征存在两种类型：原发性和继发性。本 3D 手术视频（视频 1）旨在展示 2 例原发性空蝶鞍综合征患者经硬膜外显微重塑蝶鞍的过程。这 2 例患者均签署了手术知情同意书，并同意将其影像用于研究目的。在这 2 例患者中，磁共振成像扫描显示蛛网膜下腔疝入垂体窝，并在冠状位上呈现出类似于锚的轮廓。患者术后情况良好，视觉缺陷得到改善，术后视野研究可以观察到这一点。如果由于视力丧失而需要手术，该手术被称为视交叉固定术。最近，Guinto 等人描述了一种视交叉固定术的技术。我们团队认为该手术具有技术简单、成本低等优点。由于是自体组织，排斥的可能性几乎为零。这个 3D 视频是对该技术的补充说明。
