Sellar remodeling: a surgical option for primary empty sella syndrome

The empty sella is an entity that only rarely presents signs and symptoms. When noted, visual field deficits are an indication for surgical management. We studied twenty patients with primary empty sella and visual field deficits surgically treated with a technique termed by us as "sellar remodeling." We treated 19 females and 1 male. Aside from visual deficits, all participants reported headache. We reported an increase in prolactin serum level in three cases. Patients with an increase in cerebrospinal fluid pressure were excluded. The surgical procedure involved placing through a transsphenoidal route an autologus graft formed by fat, aponeurosis and two bone lamina, with precise dimensions according to each patient's sella turcica. After surgery, visual deficits improved in 18 patients and headache in 17. Two patients displayed normal prolactin levels. No serious complications were reported during surgery. Sellar remodeling is a precise, simple, safe and inexpensive technique that significantly improves symptoms such as visual deficits and headache observed in primary empty sella syndrome.