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Journal of Korean Neurosurgical Society > Volume 44(3); 2008 > Article
Journal of Korean Neurosurgical Society 2008;44(3): 151-155.
doi: https://doi.org/10.3340/jkns.2008.44.3.151
Endocrine Outcome of Endoscopic Endonasal Transsphenoidal Surgery in Functioning Pituitary Adenomas.
Jai Ho Choe, Kun Soo Lee, Sin Soo Jeun, Jin Hee Cho, Yong Kil Hong
1Department of Neurosurgery, Kangnam St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. hongyk@catholic.ac.kr
2Department of Otolaryngology, Kangnam St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
ABSTRACT
OBJECTIVE:
Microscopic and endoscopic transsphenoidal approach (TSA) are major surgical techniques in the treatment of pituitary adenoma. Endoscopic endonasal transsphenoidal approach (EETSA) has been increasingly used for pituitary adenomas, however, its surgical outcome particularly in functioning pituitary adenoma has been debated. Here, we investigated the endocrine outcome of the patients with growth hormone (GH) and adrenocorticotropic hormone (ACTH) secreting pituitary adenoma treated by EETSA.
METHODS:
We treated 80 patients with pituitary adenoma by EETSA since 2004, of which 12 patients were affected by functioning pituitary adenomas (9 GH, 3 ACTH, 0 PRL; 9 macro, 3 micro). Surgical outcome of those patients treated by EETSA was compared with that of the 11 functioning pituitary adenoma patients (8 GH, 3 ACTH; 8 macro, 3 micro) who underwent sublabial microscopic TSA between 1997 and 2003.
RESULTS:
Imaging remission based on postoperative MRI was achieved in 8 (73%) and hormonal remission in 5 (45%) of 11 patients treated by sublabial microscopic TSA. Imaging remission was observed in 10 (83%, p=0.640) and hormonal remission in 10 (83%, p=0.081) of 12 patients by EETSA. CSF leakage was noticed in 2 (17%) of EETSA group and in 2 (18%) of sublabial microscopic TSA group. Panhypopituitarism was observed in 1 (9%) of EETSA group and in 3 (27%) of sublabial microscopic TSA group.
CONCLUSION:
EETSA appears to be an effective and safe method for the treatment of functioning pituitary adenomas.
Key Words: ACTH-secreting pituitary adenoma; GH-secreting pituitary adenoma; Endoscopy; Transsphenoidal approach
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