Visual improvement after chiasmapexy for primary empty sella turcica

Area of Science:

• Neurosurgery
• Ophthalmology
• Endocrinology

Background:

• Primary empty sella turcica is a condition where the pituitary gland is not fully developed within the sella turcica.
• It can lead to visual impairment due to compression or stretching of the optic chiasm.
• Surgical intervention is sometimes necessary to alleviate chiasmal compression.

Observation:

• A patient presented with progressive, painless visual impairment attributed to primary empty sella turcica.
• The sella turcica was found to be empty upon diagnostic evaluation.
• Optic chiasm involvement was suspected as the cause of visual decline.

Findings:

• The patient underwent a surgical procedure involving muscle packing to elevate the chiasm.
• This technique effectively addressed the chiasmal elevation without requiring a transsphenoidal approach or opening the lamina terminalis.
• Postoperative visual improvement was observed in the patient.

Implications:

• Muscle packing of the sella turcica presents a viable surgical alternative for managing visual deficits in primary empty sella turcica.
• This approach may be particularly advantageous in cases lacking dense adhesions between the optic chiasm and the sella floor.
• Further research could explore the long-term efficacy and patient selection criteria for this surgical technique.