Clinical and visual outcome of transsphenoidal surgery in nonfunctioning pituitary adenomas

ABSTRACT

The aim of this study was to evaluate the outcome of patients with nonfunctioning pituitary adenoma treated with transsphenoidal surgery, with special emphasis on the visual status and complications associated with the technique. From 1994 to 2004, 47 patients underwent transsphenoidal surgery for treatment of pituitary adenomas unassociated with clinical or biochemical evidence of hormonal overproduction. Transsphenoidal surgery using the surgical microscope and the television radiofluoroscope was performed in all cases. Visual field and acuity assessments were done before and a few weeks after surgery in both eyes. Of 94 patient's eyes assessed preoperatively, 86 [91.48%] had visual acuity and 66 [70.21%] had visual field problems. Incidence of optic atrophy in our patients' eyes was 33%. In our series, postoperative visual results were not influenced by the presence of optic atrophy. There was no statistically Significant difference between postoperative visual acuity improvement and the severity of visual acuity problems, but postoperative visual outcome was better in patients with quadranopsia or hemianopsia than patients with blindness [p < 0.05]. The mean postoperative hospitalization was 9.8 +/- 7.9 days. The percentage of surgically related complications was 19.14% and deaths was 2.12%. There were 4 instances of permanent diabetes insipidus, 2 of cerebrospinal fluid rhinorrhea, 2 of ophthalmoplegia, and one of postoperative haematoma. This low rate of postoperative complications and excellent outcome which our study showed, makes transsphenoidal surgery an attractive procedure for patients with nonfunctioning pituitary adenomas