title: Need for intrasellar packing in sellar reconstruction of transsphenoidal surgery: less is more?
abstract: BACKGROUND
  This study investigated patients with pituitary macroadenomas who received transsphenoidal surgery using two different sellar reconstruction methods, to determine the need for intrasellar packing.
  
  
  METHODS
  The authors reviewed 53 patients with pituitary macroadenomas at a single institution between January 1999 and November 2002. On tumour removal, the group 1 patients underwent traditional sellar reconstruction (intrasellar and sphenoid sinus packing), while the group 2 patients did not undergo intrasellar packing.
  
  
  RESULTS
  The two groups did not differ significantly in terms of complications. There was no mortality; notably, no delayed empty sella syndrome occurred in the group 2 patients.
  
  
  CONCLUSIONS
  Simplified reconstruction of the sella floor using only sphenoid bone without intrasellar packing is thought to be safe and effective. This technique obviates the need for a second surgical incision, risk of overpacking, complications associated with packing material and interference on postoperative magnetic resonance imaging.
authors: Department of Neurosurgery, Chang Gung University and Memorial Hospital, 222, Mai-Chin Road, Keelung 204, Taiwan, Republic of China. samchen@adm.cgmh.org.tw
authors: Hsien-Chih
authors: HC
authors: Chen
authors: Shih-Tseng
authors: ST
authors: Lee