title: Role of transsphenoidal operation in the management of pituitary adenomas with suprasellar extension.
abstract: 59 consecutive patients with suprasellar extending pituitary adenomas were operated on by the transsphenoidal approach. The suprasellar tumour extension was in 30 cases stage A (Hardy-Wilson), in 18 stage B and in 11 stage C. 14 patients were above 65 years of age and in this latter group 9 cases had large tumours (B or C). 78% of endocrinologically active tumours did not reach the chiasm (stage A) whereas 72% of functionless adenomas compressed the chiasm or grossly the third ventricle. Visual field defects and loss of visual acuity was both present in roughly 90% of stage B and C tumours. Radical surgical removal with regard to suprasellar extension was possible in all but 6 cases. Four of these patients had tumour remnants large enough to require removal by a second intracranial operation. No patient developed visual deterioration post-operatively. Pre-operative visual dysfunction was normalized or markedly improved in more than 90% of the cases. Failure to normalize vision was closely linked to the presence of pale optic discs. Pre-operative hypersecretion was normalized in 70% of the cases. Addition of permanent pituitary insufficiency occurred in three patients.
authors.affiliation: Department of Neurology, University Hospital, Linköping, Sweden.
authors.forename: O
authors.initials: O
authors.lastname: Bynke
authors.forename: J
authors.initials: J
authors.lastname: Hillman
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000601:surgery*; D012658:Sella Turcica / Q000601:surgery; D013100:Sphenoid Bone / Q000601:surgery