How successful is transsphenoidal surgery for nonfunctioning adenomas

How successful is transsphenoidal surgery for nonfunctioning adenomas?

• Transsphenoidal resection: The rates of successful NFA resection are a function of the tumor size and degree of invasiveness. Gross total resection rates are highest for tumors localized exclusively in the sella, but decreases to < 50% when there is cavernous sinus invasion or bony involvement.

• Pituitary hormone function: Transsphenoidal surgery, when performed in experienced neurosurgical centers, maintains normal pituitary gland function in the vast majority of NFA cases when function is normal preoperatively (> 85–90%) and usually improves or normalizes (15%–30%) any preoperative hormone deficiencies. In addition, new-onset pituitary hormone deficiencies, after an uncomplicated TSS, are uncommon at experienced neurosurgical centers (~ 5 to 7%). Patients with pituitary apoplexy, or who underwent repeat aggressive surgical resections, are unlikely to recovery anterior pituitary gland function. Recovery of pituitary hormone production is best assessed at 6 to 12 weeks after surgery. The recommended evaluation includes basal pituitary hormone testing (as stated above) and stimulation testing (e.g., cosyntropin or GH deficiency testing) only as indicated.

• Headaches: Headaches, particularly those associated with a retroorbital tumor location and large tumors (> 1 cm), are relieved in an estimated ≈ 70% of NFA patients postoperatively.

• Vision: Most patients with preoperative vision deficits improve, although many do not normalize entirely (≈ 30% of cases). The time course of visual field recovery includes an immediate improvement in the first week postoperatively (≈ 50%), followed by a slower recovery phase over the next 6 to 12 months. A worse prognosis for visual recovery is associated with a longer duration of preoperative vision loss.

15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856
Scroll to Top