[Surgical and endocrinological results after the removal of hormonally inactive pituitary adenomas by means of frontal craniotomy].
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Abstract
The pre- and postoperative endocrinological findings are evaluated in 128 patients suffering from pituitary adenoma without endocrine activity, undergoing surgery in the Department of Neurosurgery, University Hospital, Zürich, in the 10-year period between 1962 and 1971. The preoperative examination showed hypothyroidism in 24% of all cases. 59% of the males showed primary or secondary hypogonadism. All females in the age between puberty and menopause complained of menstrual disturbances. One patient complained of preoperative diabetes insipidus. The postoperative examination showed that the function of a partially insufficient pituitary may improve after surgery. Hypothyroidism and adrenal insufficiency became normal in 2/3 of the cases. Male hypogonadism improved in 33% of the cases. One female gave birth to a normal baby after an uncomplicated pregnancy 6 years after pituitary surgery. 16% of the cases suffered from postoperative permanent diabetes insipidus. The operative complication rate (brain edema, intracranial bleeding, epilepsy) was 32%. The immediate surgical mortality was 7% (9 patients). Recurrent adenomas were found and operated on in 9% of the cases (11 patients). Three patients had two recurrences.