经蝶鞍底硬膜抬升手术治疗原发性空泡蝶鞍综合征

Surgical treatment of primary empty sella syndrome with transsphenoidal sellar floor dura lifting

目的 探讨原发性空泡蝶鞍综合征的病因和外科治疗思路。方法 收集2011—2023年单中心7例患者,其中男2例,女5例;年龄24~70岁,平均48.3岁。所有患者术前临床症状均包含头痛及视力、视野下降等眼科症状。通过显微镜或内镜下经蝶鞍底前部抬升的手术方式治疗原发性空泡蝶鞍综合征,观察患者术后的临床疗效。结果 患者术后头痛及眼科症状均得以有效改善,所有患者术后均未出现并发症。结论 原发性空泡蝶鞍综合征是颈内动脉搏动牵拉刺激视神经及周边硬膜结构导致一系列头痛及眼科症状,通过手术将鞍底前端抬升是治疗原发性空泡蝶鞍综合征的有效手段。

Objective To investigate the etiology and surgical treatment of primary empty sella syndrome.Methods Seven patients in a single center from 2011 to 2023 were treated by means of transsphenoidal microscopic or endoscopic sellar floor dura lifting.Among them,2 were males and 5 were females,aged 24-70 years,with an average age of 48.3 years.Their preoperative clinical symptoms included headache and ophthalmic symptoms of decreased vision and visual field.Results Headache and ophthalmic symptoms disappeared after surgery,and no postoperative complications occurred in all patients.Conclusions The pulsation of internal carotid artery with the optic nerve and the dura leads to a series of headache and ophthalmic symptoms.The operation to lift the sellar floor dura is an effective treatment for primary empty sella syndrome.