Endonasal Endoscopic Transsphenoidal Pituitary Surgery for Pituitary Adenoma: A retrospective Analysis Of Surgical Outcome
- Author:
Mohd Sazafi Mohd Saad
;
Balwant Singh Gendeh
;
Salina Husain
- Publication Type:Journal Article
- Keywords:
Hypophysectomy;
Transcollumellar, Endonasal endoscopic;
Pituitary adenoma, Macroadenoma, Microadenoma, Residual tumour
- From:
The Medical Journal of Malaysia
2011;66(5):443-446
- CountryMalaysia
- Language:English
-
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
