title: The management of pituitary tumours and post-operative visual deterioration.
abstract: The indications and results of transsphenoidal surgery for pituitary adenomas are analysed. The advantages and disadvantages of Bromocriptine and radiotherapy are considered. Transsphenoidal surgery does not damage pre-existing pituitary function. It produces excellent results in micro and mesoadenomas, curing about 70-80% of patients irrespective whether the tumour produces ACTH, prolactin or growth hormone. Moreover there is a very small relapse rate. Macroadenomas of non-functioning type are also well treated by transphenoidal surgery, with a small recurrence rate as judged by CT scan follow-up. But macroadenomas secreting prolactin or growth hormone are less effectively treated by transsphenoidal surgery, only about 40% being cured. Invasive macro prolactinomas are not helped by surgery and should be treated with Bromocriptine and radiotherapy. Radiotherapy should be used sparingly and has inevitable complications. Post-operative delayed visual deterioration is caused either by recurrent tumour or radiotherapy. There is no good evidence to support the secondary empty sella syndrome as a cause of such delayed visual deterioration.
authors.affiliation: Department of Neurological Surgery, Radcliffe Infirmary, Oxford, U.K.
authors.forename: C B
authors.initials: CB
authors.lastname: Adams
mesh_terms: D000236:Adenoma / Q000601:surgery*; D004739:England; D013006:Growth Hormone / Q000378:metabolism; D049673:History, 20th Century; D006801:Humans; D009493:Neurosurgery / Q000266:history; D010911:Pituitary Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D011388:Prolactin / Q000378:metabolism; D014786:Vision Disorders / Q000209:etiology*
chemical_list: D011388:Prolactin; D013006:Growth Hormone