WITHDRAWN: Clinical observation of 19 primary pituitary abscess cases treated by transsphenoidal surgery with or without sella packing

Abstract

ObjectivePituitary abscess (PA) is a rare disease in the sellar region. This study aimed to investigate a series of PA cases with two different approaches to better understand the surgical principles and underlying mechanisms. Methods19 cases of primary PA were included for a comprehensive evaluation with special attention paid to the surgical approaches and the effectiveness and safety with or without sella packing. ResultsHeadache, and visual impairment were the most frequently seen symptoms among all patients. More than half of patients exhibited anterior pituitary dysfunction including panhypopituitarism, with a considerable portion of patients found with elevated prolactin (PRL) along with a thicker stalk on MRI. 11 patients underwent transsphenoidal surgery (TSS) without sella packing for allowing continuous drainage (Non-packing group), while the remaining 8 were operated with fat-based packing following intraoperative pus irrigation (Packing group). Both groups had similarly good outcomes including the duration of antibiotics use, complications, and hospital stay, but the incidence of abscess recurrence was higher for the packing group. ConclusionTSS without sella-packing exhibited comparable safety to the packing approach for PA and may be associated with a lower incidence of recurrence, provided that cerebrospinal fluid (CSF) leakage is well prevented.