Sellar arachnoid cysts (SACs) are a rare occurrence and, when symptomatic, they cause symptoms and signs related with the mass effect they may produce over the surrounding neurovascular structures.When needed, the surgical treatment of SACs mainly involves the marsupialization of the cyst’s wall via a transsphenoidal route or, less frequently,through a craniotomy. In such settings and in most cases, an endoscopic endonasal transsphenoidal approach represents the optimal surgical strategy for the marsupialization of SACs. Someone advocates a simple drainage of the cystic content through a limited opening of the sellar dura and the subsequent closure of the sural defect, while others favour the excision of the cyst’s membranes either partially or entirely and/or to enlarge the communication between the cyst cavity and the suprasellar subarachnoid space. Anyway, a key step of the endoscopic endonasal transsphenoidal treatment of sellar or sellar/suprasellar arachnoid cysts is the avoidance of their recurrence and, in case of communicating cysts, the prevention of the postoperative CSF leak.It should be remembered that although the transsphenoidal treatment of SACs can improve the preoperative symptoms in a relatively high percentage of patients, such treatment has been associated with the occurrence of serious complications including visual loss, postoperative CSF leak, and meningitis.

Endoscopic Endonasal Transsphenoidal Approach [Chapt. 15]

ESPOSITO, FELICE
Primo
2016-01-01

Abstract

Sellar arachnoid cysts (SACs) are a rare occurrence and, when symptomatic, they cause symptoms and signs related with the mass effect they may produce over the surrounding neurovascular structures.When needed, the surgical treatment of SACs mainly involves the marsupialization of the cyst’s wall via a transsphenoidal route or, less frequently,through a craniotomy. In such settings and in most cases, an endoscopic endonasal transsphenoidal approach represents the optimal surgical strategy for the marsupialization of SACs. Someone advocates a simple drainage of the cystic content through a limited opening of the sellar dura and the subsequent closure of the sural defect, while others favour the excision of the cyst’s membranes either partially or entirely and/or to enlarge the communication between the cyst cavity and the suprasellar subarachnoid space. Anyway, a key step of the endoscopic endonasal transsphenoidal treatment of sellar or sellar/suprasellar arachnoid cysts is the avoidance of their recurrence and, in case of communicating cysts, the prevention of the postoperative CSF leak.It should be remembered that although the transsphenoidal treatment of SACs can improve the preoperative symptoms in a relatively high percentage of patients, such treatment has been associated with the occurrence of serious complications including visual loss, postoperative CSF leak, and meningitis.
2016
978-3-319-21532-7
File in questo prodotto:
File Dimensione Formato  
Esposito_ Endoscopic Endonasal Transsphenoidal Approach.pdf

solo utenti autorizzati

Descrizione: Book chapter
Tipologia: Versione Editoriale (PDF)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 281.93 kB
Formato Adobe PDF
281.93 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11570/3069779
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 0
  • ???jsp.display-item.citation.isi??? ND
social impact