Abstract :
Background: Pituitary tumors are the third most common primary intracranial tumors. The microscopic transsphenoidal approaches are the main prefered surgical appraoches for surgical management of most cases of pituitary adenomas. Teh transsphenoidal appraoches are gaining many advantages over the microscopic transcranial approaches. The reasons for this is the low morbidity and mortality reported with the transsphenoidal appraoches. Patients and Methods: This study has been conducted 40 patients operated upon using the standard microscopic transsphenoidal pituitary adenoma resection. during the period from May/2010 to July/2012, at Department of Neurosurgery, Ain Shams University, Cairo, Egypt, all of the patients in this study had preoperative MRI brain and sella, CT sella and paranasal sinuses. Visual assessment including visual field assessment and visual acuity, hormonal assay for prolactin, grwoth hormone cortisol levle, thyroid hormones level (T3, T4, TSH) and the follow up of these patients was by MRI brain and sella after 3 months, hormonal level, visual field assessment one month postoperative and every 3 months. Results: From our 40 cases we had 4 cases with regrowth of the residual part, 4 cases with C.S.F leak and 2 cases with transient diabetes insipidus and these were the major complications we had and improvement occured in 83.3% of cases presented by visual field, and in 80% of cases presented by headache, complete hormonal control was achieved in about 44.4% of cases with hormonal disturbance. The follow up period was from 8-24 months (mean 16 months). Conclusion: The present study showed that the microscopic endonasal transsphenoidal surgery can be used in pituitary adenoma excision with avoidance of complications of transcranial route.
