Efficacy of neuroendoscopic surgery via transsphenoidal approach under guidance of intraoperative MRI for patients with giant non-functional pituitary adenomas
XIE Sen
HAN Yi-peng
MAO Geng-sheng
ZHU Wei-jie
MENG Xiang-hui
Abstract：Objective To investigate the clinical efficacy of endoscopic endonasal transsphenoidal surgery(EETS)guided by intraoperative MRI(iMRI)for patients with giant(maximum diameter>4 cm)non-functional pituitary adenomas(NFPA).Methods The clinical data of 24 patients with giant NFPA treated by EETS from February 2009 to June 2015 were retrospectively analyzed.The iMRI was used to guide surgical resection of the tumors.Results The maximum tumor diameter was 4～5 cm in 18 patients and>5 cm in 6.The iMRI scan was performed in 15 patients for 1 time,6 patients for 2 times,2 patients for 3 times,and 1 patient for 4 times;with an average of(1.5±0.8)times/case.Total resection of the tumors was achieved in 18 patients and subtotal in 6.Cerebrospinal fluid(CSF)rhinorrhea occurred in 2 patients during the operation,and CSF rhinorrhea occurred in 1 and transient diabetes insipidus in 6 after the operation.There was no intracranial infection or intracranial hematoma.The postoperative follow-up ranged from 3 months to 60 months,with a mean time of 45 months.Impairments of visual acuity or visual field were improved in 19 of 24 patients,headache was relieved in 11 of 14 patients.Hypopituitarism occurred in 3 patients and olfactory dysfunction in 4,and tumors recurred in 2 patients during the follow-up.Conclusions EETS guided by iMRI is a safe and effective method for the treatment of patient with giant NFPA,which can obtain satisfactory efficacy,high surgical safety and few complications.
Keywords：Giant non-functional pituitary adenomasIntraoperative MRIEndoscopic endonasal transsphenoidal surgeryEfficacy
Publication Date：2024-01-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 8-11 )