Bony Regeneration of the Sella after Transsphenoidal Pituitary Surgery

World Neurosurg. 2016 Apr:88:497-502. doi: 10.1016/j.wneu.2015.10.073. Epub 2015 Nov 5.

Abstract

Objective: The purpose of this study is to demonstrate the possible bony regrowth of the sella after transsphenoidal surgery without any intraoperative sellar reconstruction.

Methods: Radiologic findings of the sella were reviewed in patients with pituitary tumors treated by transsphenoidal surgery. In 17 patients who had postoperative cranial computed tomography scans, bony regeneration of the sellar floor was evaluated by comparing immediate and late postoperative scans. The bony opening reduction was measured in transverse and sagittal planes.

Results: The median bony opening diameter in the transverse plane was 8.8 mm (interquartile range [IQR] 5.7-11.4) on the first scan and 4.2 mm (IQR 0.8-6.8) on the second scan. In the sagittal plane, it was 4.8 mm (IQR 1.8-6.8) on the first scan and 2.9 mm (IQR 1.6-3.9) on the second scan. These changes occurred in a median time of 36 months (IQR 22-42). There was a statistically significant decrease of the bony opening diameters in both the transverse and sagittal planes (P < 0.0001 and P = 0.0004, respectively). Bone regeneration was observed in 16 of the 17 patients (approximately 94%).

Conclusion: There is a natural bony regeneration of the sella after transsphenoidal pituitary surgery.

Keywords: Bone regeneration; Reoperation; Sella turcica; Transsphenoidal surgery.

MeSH terms

  • Adult
  • Aged
  • Bone Regeneration*
  • Female
  • Humans
  • Hypophysectomy / methods*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Neuroendoscopy / methods*
  • Pituitary Gland / diagnostic imaging
  • Pituitary Gland / pathology
  • Pituitary Gland / surgery*
  • Radiography
  • Retrospective Studies
  • Sella Turcica / diagnostic imaging*
  • Sella Turcica / growth & development*
  • Sphenoid Bone / pathology
  • Sphenoid Bone / surgery