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Endonasal endoscopic transsphenoidal pituitary surgery for pituitary adenoma: a retrospective analysis of surgical outcome.

Abstract

The purpose of this retrospective joint rhino-neurosurgical study from January 1998 until September 2009 is to document the demographic data, clinical presentations, radiological findings, approaches and incidence of residual tumour. Forty-seven patients with pituitary adenoma underwent trans-sphenoidal hypophysectomy of which 25 patients with complete medical and radiological data were included in the study. The medical and radiological data were analyzed. There were 12 males and 13 females with age ranging from 17 to 76 years old (mean 49.2). Fourteen of the patients were Chinese, eight Malays and three Indians. Twelve of the patients had functioning tumour of which five each presented with acromegaly and Cushing disease respectively and two with amenorrhoea. The rest of 13 patients had non functioning tumour presenting with visual disturbances. Sixteen of the patients had pituitary macroadenomas and the rest 9 microadenomas. Eighteen patients had undergone transcollumellar trans-sphenoidal hypophysectomy and the rest 7 patients had undergone transnasal transsphenoidal hypophysectomy. About 68.8% of pituitary macroadenomas had residual tumour, compared to only 22.2% of patient with pituitary microadenomas. Radiologically, about 45.5% of residual macroadenoma had suprasellar extension and the majority had spread to suprasellar cistern and carvenous sinus (54.5%). About 16.6% of patients had undergone post operative radiotherapy. In conclusion, this study showed that patient with pituitary macroadenomas had higher incidence of residual tumour compared to pituitary microadenomas.

Authors

Sand MS, Gendeh BS, Husain S

Institution

UKM Medical Center, ORL-HNS, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia.

Source

The Medical journal of Malaysia 66:5 2011 Dec pg 443-6

MeSH

Adenoma
Adolescent
Adult
Aged
Endoscopy
Female
Humans
Hypophysectomy
Male
Middle Aged
Nasal Cavity
Neoplasm, Residual
Pituitary Neoplasms
Retrospective Studies
Treatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22390098