Medical evaluation of pituitary tumors in seven aircrews

LIU Jing; ZHENG Jun; LIU Hongjin; XIONG Wei; FU Zhaojun; CUI Li

Abstract：Objective To investigate the clinical diagnosis and aviation medical evaluation principles of pituitary tumors in aircrews. Methods Data on diagnosis and medical assessment of pituitary tumors in seven aircrews admitted to our hospital between 2003 and 2015 was retrospectively analyzed and related literature was reviewed. Results Four cases of pituitary macroadenomas had a headache and the optic chiasm was abutted, as was shown on cranial MRI. Besides, two of them had abnormal visual function, one had signs of acromegaly, and one had hyperprolactinemia. Another three cases of pituitary macroadenomas had no headache and no abutting optic chiasm, and one of them had galactorrhea accompanied by hyperprolactinemia. Two patients of macroadenomas received surgery and one refused, all of whom were grounded permanently. Two cases of prolactinoma were treated with bromocriptine effectively and were given qualification later. Two cases of microadenomas without any symptoms or signs were given flying qualification, so did two cases of prolactinoma after being treated with bromocriptine effectively. Conclusion Aircrews with pituitary tumors should be subjected to endocrinological, neurological and ophthalmological assessment. Medical evaluation should be based on the state of illness, therapeutic effect, aircraft types and flying duties. It is recommended that ①aircrews with obvious symptoms and signs of pituitary tumors should be disqualified; ②those with incidentally-found, asymptomatic and nonfunctional pituitary tumors should be given qualification; ③aircrews with pituitary tumors treated surgically and without complications, and cases of prolactinoma treated with drugs effectively and without any side effect should be evaluated individually. Aircrews who are specially permitted to fly should be closely followed up.