Outcomes of transsphenoidal surgery in dopamine agonist-resistant prolactinomas: a retrospective study

Abstract Objective: Analyzing the rate of structural complications after transsphenoidal surgery for removal of growth hormone (GH) secreting pituitary adenomas. Methods: Retrospective study of 58 patients who underwent microscopic transsphenoidal neurosurgery for GH secreting pituitary adenomas exeresis in Curitiba, Parana state, Brazil, between 1998 and 2011 by the same neurosurgeon. The Criteria for diagnosis of complications were clinical. Results: Five (8,6%) of the 58 patients who underwent transsphenoidal surgery developed postoperative anatomical complications, which was due to sixth cranial nerve palsy (3,4%), surgical wound infection (1,7%) and CSF fistula (3,4%). Conclusion: The rate of postoperative complications observed in the present study is likely the literature review. There is a drop in the rate of complications with increasing experience of the neurosurgeon.

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Endoscopic Endonasal Transsphenoidal Surgery for Microprolactinomas and Mesoprolactinomas as an Alternative to Dopamine Agonist Therapy

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0035-1546478 ◽

2015 ◽

Vol 76 (S 01) ◽

Author(s):

Anni Wong ◽

Zachary Mendelson ◽

Tareq Azad ◽

Jean Eloy ◽

James Liu

Keyword(s):

Dopamine Agonist ◽

Transsphenoidal Surgery ◽

Agonist Therapy ◽

Endoscopic Endonasal ◽

Dopamine Agonist Therapy ◽

Endoscopic Endonasal Transsphenoidal Surgery

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Significant headache improvement after transsphenoidal surgery in patients with small sellar lesions

Journal of Neurosurgery ◽

10.3171/2008.8.jns08805 ◽

2009 ◽

Vol 110 (2) ◽

pp. 354-358 ◽

Cited By ~ 44

Author(s):

Maria Fleseriu ◽

Christine Yedinak ◽

Caitlin Campbell ◽

Johnny B. Delashaw

Keyword(s):

Retrospective Study ◽

Postoperative Complications ◽

Brain Tumors ◽

Retrospective Review ◽

Transsphenoidal Surgery ◽

Imaging Techniques ◽

Pituitary Tumors ◽

Cushing Disease ◽

Sellar Lesions ◽

Oregon Health

Object Pituitary adenomas represent a large proportion of brain tumors that are increasing in incidence because of improved imaging techniques. Headache is the primary symptom in patients with large tumors (macroadenomas), but is also a symptom in patients with small tumors (microadenomas, tumors < 1.0 cm). The prevalence and optimal treatment of headaches associated with pituitary tumors is still unclear, particularly in cases of microadenoma. If conventional medical management fails, transsphenoidal surgery (TSS) may be considered as an alternative treatment for intractable headaches. Methods The authors conducted a retrospective review of 512 patients who underwent TSS at Oregon Health & Science University between 2001 and 2007; patients with Cushing disease were excluded. The authors identified 41 patients with small pituitary tumors who underwent TSS, and retrospectively evaluated the resolution and/or treatment of headache. Results Ninety percent of patients who presented with nonfunctioning microadenomas and Rathke cleft cysts experienced resolution or improvement in their headaches after TSS, and 56% of patients who presented with hyperfunctioning pituitary microadenomas had improvement in their headaches. There were no postoperative complications. Conclusions In this retrospective study, the authors demonstrate the efficacy of TSS in the treatment of intractable headaches in patients who present with pituitary microadenomas (nonsecreting and hypersecretory) and Rathke cleft cysts.

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