Endoscopic Endonasal Surgery for Clinically Nonfunctioning Pituitary Adenomas ()
ABSTRACT
Background: Clinically nonfunctioning pituitary adenomas (NFPAs)
are the most frequent pituitary macroadenomas, and represent approximately one-third of all pituitary adenomas. Patients
often present with symptoms of mass effects, such as visual field defects,
chronic headache, and hypopituitarism. Objective: The objective of this
study was to retrospectively analyze the surgical results of 35 patients
with non-functioning pituitary adenomas (NFPAs) operated by the endoscopic
endonasal approach (EEA). Surgical outcomes including postoperative
complications, recurrence and the postoperative visual and endocrine profile
were assessed. Results: This retrospective study included 35 patients
operated for clinically nonfunctioning pituitary adenomas (NFPAs) in Al Azhar
university hospitals treated by endoscopic endonasal approach (EEA) in the last
6 years. 65.7% (n = 23) were male and 34.3% (n = 12)
were female. The mean age was 41.5 (range 18 - 65)
years. The most common presenting symptoms were headache, with 60% of the
patients having headache. Visual disturbances were the presenting symptom in
82.9% patients and endocrinological problems (panhypopituitarism) were present
in 6 (17.1%) patients. The number of patients suffering from cranial nerve
deficit was 2 (5.7%). Visual acuity and visual field improved in 23 (79.3%)
of 29 patients. The rate of tumor recurrence/regrowth was higher in the case of giant adenomas and cavernous sinus invasion represented 11
patients (31.4%). Conclusions: Early endoscopic endonasal approach
surgery of NFPAs and effective surgical decompression reduces morbidity. Visual
deficit improves in two third of cases. NFPAs represent high rate of recurrence
due to invasion or incomplete resection especially with giant adenomas. The
recurrence rate with growth total resection (GTR) is lower than subtotal
resection (STR).
Share and Cite:
Melesy, A. (2021) Endoscopic Endonasal Surgery for Clinically Nonfunctioning Pituitary Adenomas.
Open Journal of Modern Neurosurgery,
11, 258-266. doi:
10.4236/ojmn.2021.114030.
Cited by
No relevant information.