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Updated: Aug 8, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Need for intrasellar packing in sellar reconstruction of transsphenoidal surgery: less is more?
Hsien-Chih Chen1, Shih-Tseng Lee
1Department of Neurosurgery, Chang Gung University and Memorial Hospital, 222, Mai-Chin Road, Keelung 204, Taiwan, Republic of China. samchen@adm.cgmh.org.tw
Background:
This study investigated patients with pituitary macroadenomas who received transsphenoidal surgery using two different sellar reconstruction methods, to determine the need for intrasellar packing.
Methods:
The authors reviewed 53 patients with pituitary macroadenomas at a single institution between January 1999 and November 2002. On tumour removal, the group 1 patients underwent traditional sellar reconstruction (intrasellar and sphenoid sinus packing), while the group 2 patients did not undergo intrasellar packing.
Results:
The two groups did not differ significantly in terms of complications. There was no mortality; notably, no delayed empty sella syndrome occurred in the group 2 patients.
Conclusions:
Simplified reconstruction of the sella floor using only sphenoid bone without intrasellar packing is thought to be safe and effective. This technique obviates the need for a second surgical incision, risk of overpacking, complications associated with packing material and interference on postoperative magnetic resonance imaging.
