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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