Outcomes and complications of surgical treatment for pituitary adenomas with cavernous sinus invasion
Abstract
Surgical treatment of pituitary adenomas (PA) with cavernous sinus (CS) invasion with Knosp 3 and 4 grades is a challenging problem.
THE AIM of the current study is to present the results and complications rate of surgical treatment of patients with PA with CS invasion with Knosp 3 and 4 grades via transnasal endoscopic rout.
MATERIALS AND METH ODS . The results of surgical treatment of 69 patients were retrospectively analyzed. Primary PAs were observed in 47 patients, recurrent PAs — in 22 cases, 1 patient had prior radiosurgical treatment.
RESULTS . Gross total tumor resection was achieved in 23 (33.4 %) patients, subtotal resection — in 28 (40.6 %) patients, and partial resection of the PA in 18 (26 %) patients. The most frequent complications were diabetes insipidus in 10 % (n=7) patients and nasal cerebrospinal fluid leak in 5.7 % (n=4) patients; 2.8 % (n=2) patients developed meningitis; 1.4 % (n=1) had cranial nerve III palsy; 1.4 % (n=1) developed adrenal insufficiency; 1.4 % (n=1) had intracranial hemorrhages. There were no injuries of the internal carotid artery and no mortality in the study group.
CONCLUSION: Transnasal endoscopic resection of PA with CS invasion with Knosp 3 and 4 grades can be radical with good parameters of efficacy and safety for surgeons with sufficient experience.
About the Authors
A. A. Pichugin
Kazan State Medical University; State Autonomous Institution of Health Interregional Clinical diagnostic Center
Russian Federation
Russian Federation
Kazan
B. Yu. Pashaev
Kazan State Medical University; State Autonomous Institution of Health Interregional Clinical diagnostic Center
Russian Federation
Russian Federation
Kazan
V. I. Danilov
Kazan State Medical University; State Autonomous Institution of Health Interregional Clinical diagnostic Center
Russian Federation
Russian Federation
Kazan
A. G. Alekseev
Kazan State Medical University; State Autonomous Institution of Health Interregional Clinical diagnostic Center
Russian Federation
Russian Federation
Kazan
G. R. Vagapova
Kazan State Medical University; Kazan State medical Academy
Russian Federation
Russian Federation
Kazan
T. I. Popova
Kazan State Medical University
Russian Federation
Russian Federation
Kazan
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Review
For citations:
Pichugin A.A., Pashaev B.Yu., Danilov V.I., Alekseev A.G., Vagapova G.R., Popova T.I. Outcomes and complications of surgical treatment for pituitary adenomas with cavernous sinus invasion. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2022;14(1-2):79-84. (In Russ.)
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