Síndrome intra-selar: análise de 506 cirurgias transesfenoidais

Sampaio, Pedro

doi:10.1590/S0004-282X1985000400003

Resumos

Entre 506 cirurgias transesfenoidais realizadas pelo autor, foram selecionados para análise 404 casos assim distribuidos: 396 tumores hipofisários, 4 cistos intra-selares e 4 selas vazias. Com base nos sintomas apresentados pelos pacientes delineou-se a "síndrome intra-selar" caracterizada por cefaléia, desordens visuais e desendocrinias. Esta tríade pode às vezes aparecer incompleta. Chama-se atenção para casos de tumor intra-selar com RX da sela turcica normal, onde o diagnóstico se faz apenas pelo perfil endocrinológico. Mostra o autor que o reconhecimento da síndrome intra-selar pode ser feito precocemente se está atento para ela. Enfim o tratamento pela cirurgia transesfenoidal é simples e de excelentes resultados. A mortalidade na casuística do autor foi de 0,2%.

The author has performed 506 transsphenoidal surgeries but has analyzed in this study only 404 cases. There were 396 hypophiseal tumors, 4 intrasellar cysts and 4 empty sellas. Based in the symptoms presented by the patients he describes an "intrasellar syndrome", caracterized by headache, visual disorders and hormonal abnormalities. He calls attention for intrasellar tumors with normal sella, as seen by x-ray. The diagnosis of these tumors were made only by endocrinological studies. At last he shows the advantages of transsphenoidal surgery in this pathology and the exellent results obtained. The mortality of his cases was only 0.2%.

Síndrome intra-selar: análise de 506 cirurgias transesfenoidais

lntrasselar syndrome: analysis of 506 transsphenoidal surgeries

Pedro Sampaio

Professor Titular de Neurocirurgia e Membro Titular da Academia Nacional de Medicina

RESUMO

Entre 506 cirurgias transesfenoidais realizadas pelo autor, foram selecionados para análise 404 casos assim distribuidos: 396 tumores hipofisários, 4 cistos intra-selares e 4 selas vazias. Com base nos sintomas apresentados pelos pacientes delineou-se a "síndrome intra-selar" caracterizada por cefaléia, desordens visuais e desendocrinias. Esta tríade pode às vezes aparecer incompleta. Chama-se atenção para casos de tumor intra-selar com RX da sela turcica normal, onde o diagnóstico se faz apenas pelo perfil endocrinológico. Mostra o autor que o reconhecimento da síndrome intra-selar pode ser feito precocemente se está atento para ela. Enfim o tratamento pela cirurgia transesfenoidal é simples e de excelentes resultados. A mortalidade na casuística do autor foi de 0,2%.

SUMMARY

The author has performed 506 transsphenoidal surgeries but has analyzed in this study only 404 cases. There were 396 hypophiseal tumors, 4 intrasellar cysts and 4 empty sellas. Based in the symptoms presented by the patients he describes an "intrasellar syndrome", caracterized by headache, visual disorders and hormonal abnormalities. He calls attention for intrasellar tumors with normal sella, as seen by x-ray. The diagnosis of these tumors were made only by endocrinological studies. At last he shows the advantages of transsphenoidal surgery in this pathology and the exellent results obtained. The mortality of his cases was only 0.2%.

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Full text available only in PDF format.

Trabalho realizado no Serviço de Neurocirurgia da Universidade Estadual do Rio de Janeiro (UERJ).

Rua São João Batista, 80 - 22270, Rio de Janeiro, RJ - Brasil.

1. ASA, A.L. & KALMAN, K - Histological Classification of Pituitary Disease. Clinics in Endocrinology and Metabolism. . Saunders, London, 1983, pg. 567.
2. BASKIN, D.S. & WILSON, C.B. - Transsphenoidal treatment of non neoplastic intrasselar cysts. A report of 38 cases. J. Neurosurg. 60:8, 1984.
3. BUSCH, W. - Die Morphologie der Sella turcica and ihre Beziehungen zur Hypophyse. Virchows Arch. path. Anat. 320:437, 1951.
4. Empty sella and benign intrasselar cysts. Divitiis, E; Spaziante, R. & Stella, I. - Advances and Technical Standards in Neurosurgery. Springer Verlag, Wien, 1981, pg. 1.
5. HARDY, J. - Transsphenoidal microsurgery of the normal and pathologic pituitary. Clin. Neurosurg. 16:185, 1969.
6. KOOS, W. Th. & MILLER, M.H. - Intracranial Tumors of Infants and Children. G. Thieme, Sttutgart, 1971, pg. 199.
7. LANDODT, Am. - Progress in Pituitary Adenoma Biology. Advances and Technical Standards in Neurosurgery. Springer Verlag, New York, 1978, pg. 1.
8. NEEDHAM, C.W. - Neurosurgical Syndromes of the Brain. Charles C. Thomas, Springfield, 1973.
9. OLSON, D.R.: GUIOT, D.D. & DEROME, P. - The symptomatic empty sella. Prevention and correction via the transsphenoidal approach. J. Neurosurg. 37:533, 1972.
10. SACHDEV, Y.; EVERED, D.C.; APPLEBY, A. & HALL, R. - Empty sella syndrome. Postgrad, med. J. 52:703, 1976.
11. THOMAS, J. P. & HALL, R. - Medical Management of Pituitary Disease. Clinics in Endocrinology and Metabolism. Saunders, London, 1983, pg. 771.

Datas de Publicação

Publicação nesta coleção
09 Ago 2012
Data do Fascículo
Dez 1985

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ASA, A.L. & KALMAN, K - Histological Classification of Pituitary Disease. Clinics in Endocrinology and Metabolism. . Saunders, London, 1983, pg. 567.

[2] 2. BASKIN, D.S. & WILSON, C.B. - Transsphenoidal treatment of non neoplastic intrasselar cysts. A report of 38 cases. J. Neurosurg. 60:8, 1984.

[3] 3. BUSCH, W. - Die Morphologie der Sella turcica and ihre Beziehungen zur Hypophyse. Virchows Arch. path. Anat. 320:437, 1951.

[4] 4. Empty sella and benign intrasselar cysts. Divitiis, E; Spaziante, R. & Stella, I. - Advances and Technical Standards in Neurosurgery. Springer Verlag, Wien, 1981, pg. 1.

[5] 5. HARDY, J. - Transsphenoidal microsurgery of the normal and pathologic pituitary. Clin. Neurosurg. 16:185, 1969.

[6] 6. KOOS, W. Th. & MILLER, M.H. - Intracranial Tumors of Infants and Children. G. Thieme, Sttutgart, 1971, pg. 199.

[7] 7. LANDODT, Am. - Progress in Pituitary Adenoma Biology. Advances and Technical Standards in Neurosurgery. Springer Verlag, New York, 1978, pg. 1.

[8] 8. NEEDHAM, C.W. - Neurosurgical Syndromes of the Brain. Charles C. Thomas, Springfield, 1973.

[9] 9. OLSON, D.R.: GUIOT, D.D. & DEROME, P. - The symptomatic empty sella. Prevention and correction via the transsphenoidal approach. J. Neurosurg. 37:533, 1972.

[10] 10. SACHDEV, Y.; EVERED, D.C.; APPLEBY, A. & HALL, R. - Empty sella syndrome. Postgrad, med. J. 52:703, 1976.

[11] 11. THOMAS, J. P. & HALL, R. - Medical Management of Pituitary Disease. Clinics in Endocrinology and Metabolism. Saunders, London, 1983, pg. 771.