Hipopituitarismo como debut de absceso hipofisiario / Hypopituitarism as debut of pituitary abscess

We present a case of a 20 years old woman who consults for amenorrhea and mild hyperprolactinemia. Within the functional study hypopituitarism was discover and MRI showed a cystic lesion with “ring” enhancement. Transsphenoidal resection was performed, showing purulent material. Cultures were positive for MSSA and Neisseria cinerea. Antibiotic treatment was started completing 21 days. She evolved without relapse but did not recovered pituitary function.

Estudio endoscópico de la anatomía del seno esfenoidal en cadáveres / Endoscopic study of the anatomy of the sphenoid sinus in cadavers

Introducción: El seno esfenoidal presenta una relación íntima con diversas estructuras nobles de la base del cráneo. Objetivo: El objetivo de este estudio es describir la anatomía del seno esfenoidal utilizando la vía endoscópica transnasal directa. Material y método: Médicos del Servicio de Otorrinolaringología del Hospital Barros Luco Trudeau realizaron las disecciones en cadáveres del Servicio de Anatomía Patológica de la misma institución. Se realizaron diversas mediciones de la fosa nasa en relación al seno esfenoidal y se observaron la características del seno esfenoidal en relación a las estructuras neurovasculares que se proyectan en la pared. Resultados: Se estudiaron veinte cadáveres con una mediana de edad de 70 años. El 65% eran de sexo masculino. El 65% presentó configuración selar. El 60% de los senos presentaron múltiples septos. El ostium esfenoidal se encontró en la mayoría de los casos medial al cornete superior. Se apreció proyección en el seno del 80%% de carótidas (con 5%% de dehiscencias), 85%% de nervios ópticos, 40%% de nervios maxilares, 15%% de nervios vidianos, y 15%% de celdas de Onodi. Conclusiones: El seno esfenoidal es una estructura compleja relacionada con estructuras nobles que se proyectan al interior de éste, por lo que su conocimiento acabado es fundamental para su abordaje quirúrgico y de la base de cráneo.

Introduction: The sphenoidal sinus has an intimate relationship with critical structures and their exposure in the sinus walls depend on the pneumatization degree. Aim: The aim of this study is to describe the anatomy of the sphenoid sinus using direct transnasal endoscopic approach on a sample of adult corpses. Material and method: We performed endoscopic dissection of twenty corpses of the Pathology Department of the Hospital Barros Luco Trudeau. Various measurements were made from the nostrils. A description of the neuro-vascular structures projected into the sinus was performed. Results: The median age was 70 years. 65% were male. 65% of the sinuses had sellar configuration. 60%% of the sinuses had multiple septa. The sphenoid ostium was in most cases located medial to the superior concha. 80% of the carotid arteries were projected into the sinuses (5(0)% were dehiscent). 85%% of the optic nerves, 40%% of maxillary nerves, and 15%% of vidian nerves were observed in the sinuses. Onodi cells were found in 15% of the sinuses. Conclusions: The sphenoid sinus is a complex structure adjacent to delicate structures. It is essential to be aware of these structures and their anatomical variations to perform a safe surgical approach of the sphenoid sinus and skull base.