Anterior Pituitary Function before and after Trans-sphenoidal Microsurgical Resection of Pituitary Tumors

Abstract

Anterior pituitary lobe function was measured pre- and postoperatively in 40 patients with pituitary tumors who were managed surgically by the trans-sphenoidal approach. Of 23 patients with normal anterior lobe function preoperatively, 21 (91%) were normal postoperatively. Of 17 preoperatively impaired patients, 7 (40%) regained normal function, 3 (18%) improved, 4 (24%) remained the same, and 3 (18%) were further impaired by the surgery. In this small series, the likelihood of recovery of pituitary function varied inversely with the degree of preoperative impairment and the size of the tumor, suggesting that more aggressive surgical management of small, minimally symptomatic pituitary tumors is justified.

Residual anterior pituitary function following transsphenoidal resection of pituitary macroadenomas

“…Of the patients with deficits in one axis or more preoperatively, 37% improved and 6% worsened. McLanahan, et al, 9 reported on 40 patients with tumors of all types and of varying sizes. They found that of the 12 patients with tumors less than 1 cm in size who had normal pituitary function, all retained normal function after surgery.…”

Pituitary adenomas: historical perspective, surgical management and future directions

“…reporting decreased anterior pituitary function in 12.5% of patients [182–184]. Anterior pituitary insufficiency is more likely to occur in macroadenomas and preservation of normal anterior pituitary tissue can be sufficient to maintain pituitary function [155,183,185]. Pituitary stalk manipulation during resection of microadenomas may result in temporary diabetes insipidus (DI) postoperatively in as many as 1.6–60% of trans-sphenoidal cases.…”

Normal pituitary hormone response to thyrotrophin and gonadotrophin releasing hormones in subjects exposed to elemental mercury vapour.

“…The group of dentists comprised nine men who had been practising for an average of28 (range [25][26][27][28][29][30] years, and who were still working as dentists. In this group, no information was available conceming earlier B Hg or U Hg concentrations.…”