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Journal of Korean Neurosurgical Society 1993;22(1): 83-90.
Clinical Analysis of Sellar Tumors Treated via Transsphenoidal Route.
Dong Ik Shin, Young Cho Koh, Maeng Ki Cho, Do Yun Hwang
Department of Neurosurgery, College of Medicine, Hallym University, Seoul, Korea.
Between January 1990 and August 1992 sixteen patients with sellar tumors underwent 16 transsphenoidal approaches at Kang-Nam Sacred Heart Hospital. Pathological diagnosis include 14 pituitary adenomas, of which six belonged to microadenomas and the remaining eight cases were classified as macroadenomas. Other pathologies were one craniopharyngioma and one sphenoid mucocele. Thirteen patients underwent TSA as the primary procedures and the remaining three patients were subjected to TSA as the secondary procedures to the primary treanscranial approaches. Of the 13 primary TSAs excellent or good results were achieved in 11 patients and the remaining two patients were subjected to the secondary transcranial approaches to achieve good results. Six patients with microadenomas achieved gross total or subtotal removal of their tumors in all cases(100%) however, satisfactory removal was achieved only in six macroadenoma cases(75%). There was neither surgical mortality nor major morbidity. Transient diabetes insipidus complicated in 6 patients(37.5%) and CSF rhinorrhea complicated in three cases*18.8%), which needed spinal drainage for three to ten days. Meningitis was complicated in one patient with CSF rhinorrhea(6.2%). This preliminary study agrees with that TSA is a safe and effective procedure even in macroadenoma cases.
Key Words: Transsphenoidal approach(TSA); Pituitary adenoma; Microadenoma; Macroadenoma; Diabetes insipidus; CSF rhinorrhea
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