Acute pituitary apoplexy treatment through endoscopic endonasal transsphenoidal surgery / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVETo discuss the operative techniques of endoscopic endonasal transsphenoidal surgery and perioperative management for treatment of acute pituitar y apoplexy (PA).METHODS A retrospective analysis was conducted on the clinical data of 51 pathologically diagnosed acute PA after transsphenoidal endoscopic endonasal resection at the TianJin HuanHu hospital between January 2000 and December 2013. There were 28 males and 23 females,with median age of 47 and disease course of 4h-7d.The typical clinical manifestations included headache, visual interference and pituitary dysfunction. CT scan, MRI scan and endocrinological examinations were performed in all cases before operation. Glucocorticoids were used during perioperatve period, The postoperation symptoms and the results follow-up visit after operation were recorded. RESULTS The tumors were totally removed in 42 cases and sub-totally removed in 9 cases without operative death and serious complications. The follow-up period was 1 year to 14 years. Of 47 patients with headaches before the operation, all patients were resolved after the operation; In 38 patients with sight disturbance before the operation,the sight was recovered very well in 34 patients after the operation. The visual field was recovered very well in all patients. Of 28 patients with endocrine disturbance before the operation, 22 were improved in endocrine symptom after the operation. No patient recurred.CONCLUSION The endoscopic endonasal transsphenoidal operation is safe and effective for treatment of acute PA.Appropriate perioperative management is important for the success of operation.