Aim. Clinically non-functioning pituitary adenomas range from being asymptomatic to causingsignificant hypothalamic and pituitary dysfunction and visual field defects. The object of this study was toevaluate the efficacy and safety of surgery in our cases of non-functioning pituitary adenomas.Methods. The authors performed a retrospective analysis of 154 patients who underwent resection ofnon-functioning pituitary adenomas from January 2009 through May 2011. There was 87 male and 67 female(mean age = 52.3 years; follow-up = 6 - 28 months).Results. Tumors where usually large at the time of diagnosis, commonly presenting with headache (109cases – 70.7 %), visual field defects (56 cases – 36.3 %) and hypopituitarism (80 cases – 51.8 %). Pituitaryapoplexy was the presenting symptom in 33 cases (21.4 %). Transsphenoidal surgery was the primary treatmentfor adenomas, whereas transcranial surgery was reserved for the cases in which the sphenoid sinus was notpneumatised or when the tumour was mainly extrasellar. Gross total removal was achieved in 95 out of 154patients (61.7 %). Residual tumours or tumour regrowth imposed additional surgery in 34 cases (22.0 %). Theimprovement of vision was achieved in 85.7 % of cases. Postoperatively, patients showed varying improvementof pituitary function. There were no serious operative complications. Stereotactic radiosurgery was used forcontrol of residual tumours.Conclusions. Transsphenoidal surgery remains the treatment of choice for rapid decompression ofneighbouring structures in non-functioning pituitary adenomas, often bringing to normalisation or improvementof visual and pituitary function.
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