TITLE:
Visual Disorders Outcome after Endoscopic Endonasal Trans-Sphenoidal Surgery of Pituitary Macroadenomas
AUTHORS:
Wissame El Bakkouri, Picard Hervé, Brice Dzidzinyo, Abdellaoui Anis, Boyeldieu Louise, Corré Alain, Vignal Catherine, Boucenna Malika, Ayache Denis
KEYWORDS:
Pituitary, Macroadenoma, Visual Disorder, Chiasm Compression, Endoscopy, Transsphenoidal
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.5 No.3,
May
17,
2016
ABSTRACT: Objective: Describe the outcome of visual disorders after endonasal
transsphenoidal (EET) surgery of pituitary macroadenomas with preoperative chiasmal
compression. Patients and Methods: From 2009 to 2013, 225 patients underwent
EET surgery for sellar tumor. Among them, 168 suffered from visual disorders
induced by chiasmatic compression, of which 88 met the inclusion criteria for
this study. Average duration of follow up was 1.8 yrs ± 0.4 yrs. All patients
had sellar MRI before surgery and yearly postoperatively, visual acuity (VA)
and/or visual field (VF) measurements before, 3 months after surgery and yearly
postoperatively. Results: All tumors were macroadenomas with a mean
preoperative MRI-estimated volume of 10.0 {plus minus} 9.07 cm3.
Preoperative VA was impaired with an average of 0.43 ± 0.13 LogMAR (left eye)
and 0.36 ± 0.14 LogMAR (right eye) and VF was disturbed in 99% ± 2% of the
cases with the most frequent disorder being bitemporal hemianopsia (38
patients). Post-operatively, the mean residual MRI-estimated tumor volume was
3.15 ± 3.71 cm3. Mean tumor volume reduction was 62% ± 9% (p