A Case of Blindness after Transsphenoid Approach for Pituitary Adenoma Removal: Revision Treatment Experience under Local Anesthesia.
- Author:
Hyo Jin PARK
1
;
Jin Woo LIM
;
Young Han LIM
;
Young Soo RHO
Author Information
1. Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Hallym University, Seoul, Korea. mccaffity@hanmail.net
- Publication Type:Case Report
- Keywords:
Transsphenoidal surgery;
Pituitary disease;
Local anesthesia;
Complications
- MeSH:
Anesthesia, General;
Anesthesia, Local*;
Arachnoid;
Blindness*;
Cerebrospinal Fluid;
Congenital Abnormalities;
Craniotomy;
Decompression;
Hematoma;
Hemorrhage;
Humans;
Lacerations;
Membranes;
Nasal Septal Perforation;
Nose;
Optic Nerve;
Pia Mater;
Pituitary Diseases;
Pituitary Neoplasms*;
Visual Fields
- From:Journal of Rhinology
2005;12(2):120-123
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Pituitary adenoma accounts for 10% to 20% of intracranial tumors. Surgical approach to pituitary adenoma had been performed via craniotomy until the early 20th century, but transsphenoidal approach has been accepted as a primary procedure since 1910. However, there are frequent complications in the nose including nasal mucosal laceration, nasal septal perforation, and external nose deformities. Furthermore, cerebrospinal fluid leakage, visual field loss or blindness rarely occur. When blindness occurs by postoperative hematoma compression, revision operation is usually required for bleeding control and hematoma removal under general anesthesia. However, optic nerve decompression with postoperative hematoma removal via transsphenoidal approach can be adequately performed by endoscopic technique under local anesthesia, because there is no sensory nerve innervation in the pia mater and arachnoid membrane. We report a case of successful hematoma removal with bleeding control by endoscopic technique under local anesthesia in a patient who became blind due to postoperative hematoma after transphenoid approach for pituitary adenoma removal.
