Transsphenoidal extradural chiasmapexy in the management of the symptomatic primary empty sella syndrome.

When patients with the usually clinically silent primary empty sella syndrome become symptomatic through visual field defects or hormonal deficits the condition was frequently treated by a transsphenoidal intradural procedure with a risk of consecutive CSF leak or meningitis. We present 3 cases in which we performed a transsphenoidal extradural procedure packing the sella and sphenoid sinus with fat tissue and discuss the procedure and results.