Extradural balloon obliteration of the empty sella - Report of three cases(intrasellar balloon obliteration)

Empty sella syndrome is an anatomical and clinical entity composed of intra sellar reposition of the CSF and compression of the pituitary tissue, resul ting in a clinical picture of headache, visual field defect, CSF rhinorrhea and some mild endocrinological disturbances. While some cases are primary with no appreciable aetiology, secondary cases are associated with prior op eration or radiotherapy of the region. In our series, 3 patients with primary empty sella syndrome were treated by the current approach of extradural filling of the sellar cavity. This tech nique was first described by Guiot and widely accepted thereafter. We used a detachable silicon balloon filled with HEMA or liquid silicone for oblite ration of the sellar cavity and obtained clinically satisfactory results wi thout complications. Visual symptoms regressed and headache disappeared. Bu t at long term follow-up all the balloons were found to be deflated. Despit e the facility and efficacy of the technique we do not recommend it in the treatment of the empty sella because the filling of the sella is only trans ient and relapses may occur.