{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T01:45:24Z","timestamp":1784684724027,"version":"3.55.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:p>Visual deterioration after dopamine-agonist treatment of prolactinomas associated with empty sella syndrome and secondary optic apparatus traction is a rare event. Chiasmapexy has been described as a viable treatment option, although few cases exist in the literature. Here, a novel endonasal endoscopic approach to chiasmapexy is described and its efficacy is demonstrated in a case report.<\/jats:p>\n<jats:p>A 55-year-old female patient with a history of a giant prolactinoma and 14 years of treatment using dopaminergic agonist therapy presented to our institution with a 1-month history of visual changes. Neuroophthalmological examination confirmed severe bitemporal field defects, and MRI revealed a large empty sella with downward optic chiasmal herniation. Endoscopic endonasal chiasmapexy was performed by elevating the chiasm with lumbar drainage and filling the clival and sellar defect with an extradural liquid (HydroSet; a cranioplasty bone cement), and a piece of AlloDerm was used to cover and cushion the chiasm. Postoperative imaging demonstrated successful anatomical elevation of the optic apparatus, and the patient showed functional improvement in the visual field at 3 months postoperatively.<\/jats:p>\n<jats:p>Although rare, massive empty sellar and chiasmal descent from macroadenoma treatment can result in progressive visual loss. Here, a novel technique of endonasal endoscopic extradural cranioplasty aided by lumbar drainage is reported, which appears to be an effective technique for stabilizing and possibly reversing anatomical and visual deterioration.<\/jats:p>","DOI":"10.3171\/2015.2.jns142015","type":"journal-article","created":{"date-parts":[[2015,9,4]],"date-time":"2015-09-04T13:59:26Z","timestamp":1441375166000},"page":"1025-1031","source":"Crossref","is-referenced-by-count":13,"title":["Endonasal endoscopic transsphenoidal chiasmapexy using a clival cranial base cranioplasty for visual loss from massive empty sella following macroprolactinoma treatment with bromocriptine: case report"],"prefix":"10.3171","volume":"124","author":[{"given":"G. Rene","family":"Alvarez Berastegui","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaan M.","family":"Raza","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay K.","family":"Anand","sequence":"additional","affiliation":[{"name":"Otolaryngology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Otolaryngology, and"},{"name":"Neuroscience, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns142015","series-title":"Can J Neurol Sci","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1017\/S0317167100005060","article-title":"Brain & chiasmal herniations into sella after medical treatment of prolactinoma","volume":"33","author":"Bangash","year":"2006"},{"key":"b2-jns142015","series-title":"Virchows Arch","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1007\/BF00957474","article-title":"Die Morphologie der Sella turcica und ihre Beziehungen zur Hypophyse","volume":"320","author":"Busch","year":"1951"},{"key":"b3-jns142015","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1227\/01.NEU.0000137330.02549.0D","article-title":"Endoscopic endonasal transsphenoidal surgery","volume":"55","author":"Cappabianca","year":"2004"},{"key":"b4-jns142015","series-title":"J Neuroophthalmol","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1097\/00041327-200206000-00008","article-title":"Delayed visual loss following pergolide treatment of a prolactinoma","volume":"22","author":"Chuman","year":"2002"},{"key":"b5-jns142015","series-title":"Proc Staff Meet Mayo Clin","first-page":"15","article-title":"Radiation therapy of pituitary adenomas with associated visual impairment","volume":"37","author":"Colby","year":"1962"},{"key":"b6-jns142015","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1007\/s007010050265","article-title":"Delayed visual deterioration after surgery for pituitary adenoma","volume":"141","author":"Czech","year":"1999"},{"key":"b7-jns142015","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"527","DOI":"10.3171\/jns.1977.46.4.0527","article-title":"Transsphenoidal chiasmapexy for correction of posthypophysectomy traction syndrome of optic chiasm. 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