@article{oai:kanazawa-u.repo.nii.ac.jp:00026956,
 author = {笹川, 泰生 and 立花, 修 and 道合, 万里子 and 林, 康彦 and 利波, 久雄 and 飯塚, 秀明 and 中田, 光俊 and Sasagawa, Yasuo and Tachibana, Osamu and Doai, Mariko and Hayashi, Yasuhiko and Tonami, Hisao and Iizuka, Hideaki and Nakada, Mitsutoshi},
 issue = {4},
 journal = {Pituitary},
 month = {Aug},
 note = {Purpose: To analyze the clinical characteristics of acromegalic patients with empty sella (ES, herniation of the subarachnoid space within the sella turcica) and the impact of ES on transsphenoidal surgery in such patients. Methods: Seventy-eight patients, newly diagnosed with acromegaly who underwent transsphenoidal surgery were included. ES was defined as the pituitary gland and adenoma occupying less than 50% of the sella turcica on midsagittal magnetic resonance (MR) imaging. Results: Twelve patients (15.4%), predominantly female (10 women, p = .047), had ES in preoperative MR imaging. ES patients had smaller mean tumor diameter (6.3 mm) than non-ES patients (11.2 mm, p = .001). In preoperative MR imaging, occult adenoma was found in three (25%) ES and three (4.5%) non-ES patients (p = .044). Intraoperative cerebrospinal fluid (CSF) leakage was more frequent in the ES patients than in the non-ES patients (58.3 vs. 25.8%, p = .024). This led to an increased rate of sellar floor reconstruction using abdominal fat and/or postoperative lumber drainage in the ES patients (ES: 41.7 vs. non-ES: 16.7%, p = .063). Endocrinological remission after surgery was more frequent in the non-ES patients (72.7%) than in the ES patients (58.3%) (p = .248). Conclusions: Co-existence of acromegaly with ES is not rare, and is associated with occult adenoma, intra/postoperative CSF leakage, and a worse endocrinological outcome after transsphenoidal surgery; although, the underlying mechanism remains unclear. © 2017 Springer Science+Business Media New York, Embargo Period 12 months},
 pages = {403--408},
 title = {Clinical characteristics of acromegalic patients with empty sella and their outcomes following transsphenoidal surgery},
 volume = {20},
 year = {2017}
}