Microsurgical Transsphenoidal Approach in Sellar and Parasellar Lesions.

Lee, Kyu Sung; Chung, Sang Sup; Lee, Kyu Chang; Kim, Young Soo; Choi, Joong Uhn; Park, Yong Gu; Lee, Hun Jae

Original Article

Journal of Korean Neurosurgical Society 1981;10(1): 161-172.

Kyu Sung Lee, Sang Sup Chung, Kyu Chang Lee, Young Soo Kim, Joong Uhn Choi, Yong Gu Park, Hun Jae Lee

Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.

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.