Microsurgical Transsphenoidal Approach in Sellar and Parasellar Lesions

ABSTRACT

Fifty seven transsphenoidal microsurgery was performed in 55 patients with pituitary tumors and other juxtasellar lesions during 4 years since 1976 at Yonsei University Hospital. The results were analyzed and evaluated as follows 1) Fourty seven(85.5%) of 55 patients had pituitary tumors, most of whom were in third to fifth decade. 2) Main symptoms in the patients with pituitary tumors were headache(78.7%), visual symptoms(70.2%) and endocrine symptoms such as amenorrhea-galactorrhea(46.8%). 3) Endocrinological diagnosis of pituitary tumor revealed non-secreting adenomas in 30.8% and secreting adenomas in 69.2% of the patients. Prolactinomas were 71.8% of the secreting adenomas. 4) Improvement of the visual symptoms were seen in 57.9% of patients with diminished visual acuity and 70.9% of the patients with visual field defect. 5) Menstruation was returned in 4 patients among 5 patients of microprolactinoma treated by transsphenoidal microsurgery combined with Bromocriptine therapy. One of them delivered a normal baby and another patient is in pregnancy. 6) Mortality rate of transsphenoidal approach was 1.8%(1/57) and recurrence rate after transsphenoidal approach for pituitary tumors was 4.2%(2/47). 7) Trans-sphenoidal approach was thought to be relatively simple and safe for the surgery of pituitary and juxtasellar lesions.