Spaziante R, de Divitiis E, Cappabianca P
Neurosurgery. 1985 Sep;17(3):453-8. doi: 10.1227/00006123-198509000-00009.
Even though the main problems of transsphenoidal surgery are encountered during the intra- and suprasellar portions of the operation, proper reconstruction of the sella turcica plays an important role in the overall results, greatly influencing the final outcome. Improper measures may bring about a complicated postoperative course, whereas a wise and precise method allows one to control any surgical condition, preventing the more dangerous consequences of the transsphenoidal approach (i.e., empty sella, cerebrospinal fluid leakage, hemorrhage, infection, etc.). The authors review the different methods of sellar plugging and, on the basis of their own experience, indicate the most suitable one for each of the more usual situations. A good result is achievable if only natural materials are used and one avoids synthetic prostheses. Extradural packing is the technique of choice whenever a hermetic closure and a particularly effective intrasellar plug are required.
尽管经蝶窦手术的主要问题出现在手术的鞍内和鞍上部分，但蝶鞍的妥善重建对整体手术效果起着重要作用，极大地影响最终结果。不当的措施可能导致复杂的术后病程，而明智且精确的方法能让人控制任何手术情况，预防经蝶窦入路带来的更危险后果（如空蝶鞍、脑脊液漏、出血、感染等）。作者回顾了蝶鞍填塞的不同方法，并根据自身经验指出了针对每种常见情况最合适的方法。如果仅使用天然材料并避免使用合成假体，就能取得良好效果。当需要进行密闭缝合和特别有效的鞍内填塞时，硬膜外填塞是首选技术。
