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  • Title: Progressive visual loss because of a suprasellar pneumatocele after trans-sphenoidal resection of a pituitary adenoma.
    Author: Lee AG, Van Gilder JC, White ML.
    Journal: J Neuroophthalmol; 2003 Jun; 23(2):142-4. PubMed ID: 12782927.
    Abstract:
    A 63-year-old man who underwent uneventful trans-sphenoidal resection of a pituitary adenoma with fat packing complained postoperatively of progressive binocular visual acuity loss. Neuroimaging showed a suprasellar pneumatocele compressing the optic chiasm and a communication between the sphenoid sinus and the sella. After a second trans-sphenoidal procedure to remove the air and fully pack the sphenoid sinus, visual acuity recovered dramatically. A rare complication of trans-sphenoidal surgery for pituitary adenoma, suprasellar pneumatocele probably forms through a ball-valve mechanism that results from incomplete packing of the sellar floor. This case highlights the need for effective sphenoid sinus packing and for ophthalmic monitoring after trans-sphenoidal surgery.
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