5-YEAR FOLLOW-UP OF NONSECRETING PITUITARY-ADENOMAS

Nowadays, nonsecreting pituitary adenomas are usually operated on by m eans of a transsphenoidal approach, and the transseptal way is the mos t widely used. Since 1982 we have been using lateral rhinotomy instead , resecting bone in the piriform aperture up to the orbit to:obtain a good intrasellar view during surgery. In all, 48 patients were operate d on between 1982 and 1987, and all of them have since been evaluated in a 5-year follow-up. The only recurrence occurred in the only patien t previously operated on transcranially. Computed tomography was perfo rmed in 44 patients (92%) after an average of 4 years and revealed no signs of tumor in any of them. New pituitary insufficiencies developed in six (12%). An improvement in vision was observed in 38 patients (7 9%), none of whom suffered an impaired visual field or acuity. The fre quency of new hormonal insufficiencies and improvement of vision that we observed in our patients is comparable with that reported by other investigators, but the recurrence rate is lower and the optic ner-es a nd chiasma were never damaged thereby causing an impairment of vision. These benefits can most probably be explained by the surgical approac h we used, in which the tumor and surrounding structures are very well visualized because the operative field is broader and closer than it is with the transseptal approach, which is normally used for this kind of tumor.