Surgical treatment of non-functioning pituitary macroadenomas by the endoscopic endonasal approach in the elderly.
Over the past three decades, surgical series of elderly patients treated for pituitary adenomas have been published, all of which used the microscopic transsphenoidal or transcranial approach. The objective of this study was to retrospectively analyze the surgical results of our first 25 elderly patients with non-functioning pituitary macroadenoma (NFPM) operated by the endoscopic endonasal approach (EEA). Preoperative visual loss was found in 92.8% of the cases, and 70.8% experienced visual improvement following surgery. Preoperative pituitary dysfunction was found in 69.2% of the cases and postoperative pituitary recovery occurred in 22.2% of them. Mean hospital stay was 6.7 days. The results of this study suggest that surgery remains the first line of treatment for NFPM in the elderly. Because age alone is not a barrier for surgery, patients should be selected for surgical treatment based on their symptoms and clinical condition, as defined by comorbidities.
Departamento de Otorrinolaringologia, Universidade Federal de São Paulo, São Paulo, SP, BR.
Horacio Armando
HA
Marenco
Departamento de Otorrinolaringologia, Universidade Federal de São Paulo, São Paulo, SP, BR.
Samuel Tau
ST
Zymberg
Departamento de Otorrinolaringologia, Universidade Federal de São Paulo, São Paulo, SP, BR.
Rodrigo de Paula
Rde P
Santos
Departamento de Otorrinolaringologia, Universidade Federal de São Paulo, São Paulo, SP, BR.
Cláuder Oliveira
CO
Ramalho
D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000368:Aged; D004700:Endocrine System Diseases; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging / Q000473:pathology; D019635:Neurosurgical Procedures / Q000379:methods*; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies