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Updated: May 9, 2026
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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
I'm stuffed; visual loss after trans-sphenoidal adenomectomy.
Amanda Dinsmore1, Christopher Compton1, Lanning Kline1
1Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, Alabama.
Survey of Ophthalmology
|August 6, 2013
Summary
A patient experienced vision loss after pituitary surgery due to overpacking of a fat graft. Prompt surgical revision successfully restored her vision, highlighting the importance of graft management in trans-sphenoidal surgery.
Area of Science:
- Neurosurgery
- Ophthalmology
- Endocrinology
Background:
- Trans-sphenoidal surgery is a common approach for pituitary adenoma resection.
- Effective management of the sella turcica graft is crucial for preventing postoperative complications.
Observation:
- A 61-year-old woman presented with bilateral decreased vision 30 hours post-uncomplicated trans-sphenoidal pituitary adenoma resection.
- Postoperative imaging revealed overpacking of the sella turcica with a fat graft.
Findings:
- Overpacking of the sella turcica with a fat graft can lead to significant visual impairment.
- Urgent surgical re-exploration for fat graft reduction resulted in visual improvement.
Implications:
- This case underscores the critical role of meticulous graft placement and volume control in trans-sphenoidal surgery.
- Early recognition and intervention for graft-related complications are essential for favorable visual outcomes.
