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KMID : 0942820040030020095
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Journal of Korean Brain Tumor Society
2004 Volume.3 No. 2 p.95 ~ p.102
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The Efficacy of Transsphenoidal Approach for Pituitary Tumors
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Jeon Jin-Ho
Cha Seung-Heon
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Abstract
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Objective: The transsphenoidal approach(TSA) for pituitary tumor has evolved significantly since it was described initially during the first decade of the 20th century. This study was to evaluate the efficacy of TSA and prognosis of pituitary tumor after TSA.
Methods: We analyzed 51 cases of pituitary tumor which underwent transsphenoidal approach about radiologic findings, symptoms, results and prognosis from 2000 to 2002 with literature review. Statistical analysis was performed using paired t-test with SPSS Ver 11.0 and considered significant for value less than 0.05.
Results: There were 35 functional adenomas, 11 nonfunctional adenomas and 5 other lesions among 51cases. Follow up MRIs show that remnant mass after TSA existed on medial compartment of cavernous sinus and suprasellar area that didn’t descend during TSA in spite of valsalva maneuver. 7 cases(13.7%) recurred after TSA. Among them 3 case underwent repeated TSA and the other 1 case endured transcranial approach and gamma-knife radiosurgery applicated to another 2 cases. There was statistical significance between stage and extent of removal(p=0.0005). There were no significant complications and mortality related to TSA.
Conclusion: Although remnant rate of pituitary tumor after TSA was 45%, this approach offered excellent decompression to optic chiasm and could be a safe and effective approach to pituitary tumor if it is supported with endoscope introduction to sellar fossa and additional therapy such as gamma-knife radiosurgery.
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KEYWORD
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Pituitary adenoma, Transsphenoidal approach, Nonfunctional adenoma, Remnant tumor
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