TRANSSPHENOIDAL MICROSURGICAL MANAGEMENT OF PITUITARY-ADENOMAS

The transsphenoidal microsurgical operation is the best choice for mos t pituitary adenomas, whether or not there is an extension into the sp henoid or a supra-sellar extension without lateral spread, The advanta ge of this approach is that it allows selective removal of the adenoma and therefore can preserve normal pituitary function. In our series o f 249 cases 79% had achieved a remission at follow-up one year or more after surgery. The surgical failure rate was 21%, and the mortality r ate 0.8%. Complications occurred in 5.6%; most were temporary and mini mal. The recurrence rate after transsphenoidal microsurgery was lower than that quoted in the literature after craniotomy. The smaller the s ize of the adenomas and the less the hormone abnormality preoperativel y, the better the outcome. (C) 1994 Wiley-Liss, Inc.