Endovideomonitoring in Transsphenoidal Surgery of Pituitary Neoplasms
V.Yu. Cherebillo, V.R. Gofman, A.V. Polezhaev, V.A. Manukovsky
Chair of Neurosurgery, Medicomilitary Academy, Saint Petersburg, Russia
Materials and Methods
During the last decades Clinics of Neurosurgery and Otorhinolaryngology of the Medicomilitary Academy gained a rather profound experience in surgery of pituitary adenomas, using a transnasosphenoidal approach. It was applied in 614 patients, operated during the last 7-8 years. The mean age was equal to 37.
The male/female ratio was 1:1.8. Chromophobic, acidophilic and basophilic adenomas were watched in 68%, 29% and 3% of cases respectively. Adenocarcinomas were present in 0.8%.
According to hormonal activity all adenomas were divided into prolactinomas (20.1%); somatotroph (24.8%), corticotroph (9.1%), gonadothroph (0.9%), thyrotroph (0.2%) and nonfunctioning (44.9%) adenomas.
The tumor growth was as follows: suprasellar - 42%, parasellar - 11%, retrosellar -3%, antesellar - 2%, infrasellar - 21% and total -11%. Besides, there were endosellar adenomas (3%) and microadenomas (7%).
Vision impairment was present in 74% of patients; hormonal disorders were watched in 68% of cases (hypersecretion - 55% and hypopituitary disorders - 13%). General cerebral symptoms and oculomotor disturbances were typical of 76% and 6% of patients respectively.
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