Endoscopic Endonasal Approach to the Growth Hormone–Secreting Pituitary Adenomas: Endocrinologic Outcome in 68 Patients

Zeinalizadeh, Mehdi; Sadrehosseini, Seyed Mousa; Ardakani, J Behjati; Nakhjavani, Manouchehr; Zeinalizadeh, Mehdi

doi:10.1016/j.wneu.2018.06.009

Cited by 30 publications

(25 citation statements)

References 32 publications

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“…2%. [22][23][24][25][26][28][29][30][31][32][33][35][36][37][38][39][40][41][42][43]50 The rate of recovery from hormonal deficits in our study is greater than that found by other researchers. Most of our patients (83.9%) showed stable or improved hormonal deficits.…”

Section: Perioperative Outcomescontrasting

confidence: 64%

“…However, the CSF leak rate has significantly dropped from 25% to 3.6% (P < 0.05) after using vascularized nasoseptal flaps and proper skull base reconstruction, especially in extended EES cases, and the results were comparable with similar studies. 23,25,28,29,33,[41][42][43]56,57 Of our patients, 7.1% experienced meningitis, whereas the prevalence of this in other studies generally ranged from 0%e4.1%. The 30-day mortality rate was 0%, and in the other studies it ranged from 0%e4%.…”

Section: Perioperative Outcomescontrasting

confidence: 54%

“…Other studies have reported rates of vision improvement from as low as 23% to as high as 100%. [22][23][24][25][26][28][29][30][31][32][33][34][37][38][39][40][41][42][43]50 In our study, no patients had worsened vision after surgery. This is consistent with results found by other researchers who generally saw a very low rate of worsened visual deficits after surgery, on the order of 0%e3.…”

Section: Perioperative Outcomessupporting

confidence: 40%

“…Six (10.7%) of our patients experienced this complication, whereas the existing literature estimates this complication occurring in 0%e7.7% of cases. 22,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][40][41][42][43]50 In terms of the other postoperative complications, our study showed increased rates of postoperative CSF leak and meningitis. Among our patients, 14.3% experienced postoperative CSF leak.…”

Section: Perioperative Outcomesmentioning

confidence: 92%

“…Rates of new deficits in other studies have ranged from 0% to 20%. [22][23][24][25][26][27][28][29][30][31][32][33]35,[37][38][39][40][41][42][43][50][51][52][53][54] Perioperative complications that we analyzed include the rates of hematoma requiring evacuation, diabetes insipidus, CSF leak, and meningitis. Our patients experienced a similar rate of postoperative hematoma when compared with previous studies described in the literature.…”

Section: Perioperative Outcomesmentioning

confidence: 99%

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Challenges, Learning Curve, and Safety of Endoscopic Endonasal Surgery of Sellar-Suprasellar Lesions in a Community Hospital

et al. 2020

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BACKGROUND AND OBJECTIVE: Endoscopic endonasal surgery (EES) for the management of sellar, suprasellar, and anterior skull base lesions is gaining popularity. Our aim was to analyze and present the clinical outcomes of EES for the management of these lesions in a community hospital setting.-METHODS: We retrospectively reviewed the charts of 56 patients with sellar, suprasellar, and anterior skull base lesions who underwent EES between 2010 and 2018.-RESULTS: There was male predominance (53.6%) with a mean age of 54.9 AE 13.7 years. Lesions were 45 pituitary adenomas, 5 meningiomas, 3 metastatic, 1 craniopharyngioma, 1 Rathke cyst, and 1 mucocele. Gross total excision was achieved in 57.1%, subtotal excision occurred in 37.5%, and decompression and biopsy were achieved in 5.4% patients. Postoperative vision normalized or improved in 27 patients (86.1%) and was stable in 4 patients (13.9%). Recovery of a preexisting hormonal deficit occurred in 13 (23.2%) patients, and a new hormonal deficit occurred in 9 patients (16.1%). The mean hospital stay was 6.1 AE 4.9 days. Postoperative complications included cerebrospinal fluid leak in 8 patients (14.3%). Four patients (7.1%) had meningitis. Diabetes insipidus was present in 19 patients (33.9%), and postoperative intracranial hematoma requiring evacuation was necessary in 2 patients (3.6%). The mean follow-up duration was 47.5 AE 25.8 months. Lesion progression or recurrence requiring redo surgery occurred in 5 patients (8.9%). Regarding the learning curve, the postoperative cerebrospinal fluid leak, meningitis, new hormonal deficits, and diabetes insipidus decreased in the second half of the patients.-CONCLUSIONS: EES provides an effective and safe surgical option with low morbidity and mortality for the treatment of sellar, suprasellar, and anterior skull base lesions in a community hospital setting.

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