Volume 1, Issue 3 (12-2015)                   Iran J Neurosurg 2015, 1(3): 11-15 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Shirvani M, Hajimirzabeigi A, Jafari R, Khatami M, Razzaghi A, Yousefzadeh-Chabok S. Microscopic Transsphenoidal Surgery for Pituitary Adenomas in Children and Adolescents. Iran J Neurosurg. 2015; 1 (3) :11-15
URL: http://irjns.org/article-1-18-en.html
Abstract:   (1883 Views)

Background & Aim: We described the presentation, management and subsequent treatment outcomes of children and adolescents diagnosed with a pituitary adenoma in a joint neuroendocrine setting followed up by a single service as well as assessing long-term outcomes in terms of endocrine status and neurology symptoms.

Methods & Materials/Patients: A total of 21 participants with histologically verified pituitary adenoma between January 2011 and June 2014 were studied. Patients' data from clinical, radiological and pathological records were analyzed using SPSS (Version 16).

Results: All these children and adolescents with pituitary adenomas were managed with microscopic transsphenoidal surgery. The most common symptom was Cushing (47.6%, n=10). The functional type (76.2%, n=16) was more than the non-functional. The post-operative control MRI of most of them was clear (90.5%, n=19). The lab control of most of them was normal (76.2%, n=16). Apoplexy was seen in 5 patients (33.8%). Gross-total resection (GTR; 100% tumor removal as judged by early post-operative imaging) was achieved in 19 cases. Only one of these patients showed evidence of radiologic recurrence.

Conclusion: In our study, all patients underwent microscopic transsphenoidal surgery due to limitation of endoscopic approach in pediatric and avoided wide anatomical deficit. Doing a comparative study between these two approaches will bring about promising results.

Full Text [PDF 295 kb]   (975 Downloads) |   |   Full Text (HTML)  (99 Views)  
Type of Study: Research | Subject: Gamma Knife Radiosurgery
* Corresponding Author Address: * Corresponding Author Address: Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Guilan, Iran. Tel:+981333368773 Fax:+981333339842. Email:sh.yousefzadeh@gmail.com

References
1. Gittleman H, Ostrom QT, Farah PD, Ondracek A, Chen Y, Wolinsky Y, et al. Descriptive epidemiology of pituitary tumors in the United States, 2004–2009: Clinical article. Journal of neurosurgery. 2014;121(3):527-35. [DOI:10.3171/2014.5.JNS131819] [PMID]
2. Tarapore PE, Sughrue ME, Blevins L, Auguste KI, Gupta N, Kunwar S. Microscopic endonasal transsphenoidal pituitary adenomectomy in the pediatric population: Clinical article. Journal of Neurosurgery: Pediatrics. 2011;7(5):501-9. [DOI:10.3171/2011.2.PEDS10278] [PMID]
3. Steele CA, MacFarlane IA, Blair J, Cuthbertson DJ, Didi M, Mallucci C, et al. Pituitary adenomas in childhood, adolescence and young adulthood: presentation, management, endocrine and metabolic outcomes. European Journal of Endocrinology. 2010;163(4):515-22. [DOI:10.1530/EJE-10-0519] [PMID]
4. Taşkapılıoğlu MÖ, Yilmazlar S, Eren E, Tarım O, Moralı Güler T. Transnasal Transsphenoidal Surgical Method in Pediatric Pituitary Adenomas. Pediatric neurosurgery. 2014;50(3):128-32. [DOI:10.1159/000381862] [PMID]
5. Gondim JA, Almeida JPC, Albuquerque LAF, Schops M, Gomes E, Ferraz T, et al. Endoscopic endonasal approach for pituitary adenoma: surgical complications in 301 patients. Pituitary. 2011;14(2):174-83. [DOI:10.1007/s11102-010-0280-1] [PMID]
6. Cho HJ, Kim H, Kwak YJ, Seo JW, Paek SH, Sohn C-H, et al. Clinicopathologic analysis of pituitary adenoma: A single institute experience. Journal of Korean medical science. 2014;29(3):405-10. [DOI:10.3346/jkms.2014.29.3.405] [PMID] [PMCID]
7. Flier JS, Underhill LH, Klibanski A, Zervas NT. Diagnosis and management of hormone-secreting pituitary adenomas. New England Journal of Medicine. 1991;324(12):822-31. [DOI:10.1056/NEJM199103213241207] [PMID]
8. Abosch A, Tyrrell JB, Lamborn KR, Hannegan LT, Applebury CB, Wilson CB. Transsphenoidal microsurgery for growth hormone-secreting pituitary adenomas: initial outcome and long-term results. The Journal of Clinical Endocrinology & Metabolism. 1998;83(10):3411-8. [DOI:10.1210/jcem.83.10.5111] [PMID]
9. Ross DA, Wilson CB. Results of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma in a series of 214 patients. Journal of Neurosurgery. 1988;68(6):854-67. [DOI:10.3171/jns.1988.68.6.0854] [PMID]
10. Bodhinayake I, Ottenhausen M, Mooney MA, Kesavabhotla K, Christos P, Schwarz JT, et al. Results and risk factors for recurrence following endoscopic endonasal transsphenoidal surgery for pituitary adenoma. Clinical neurology and neurosurgery. 2014;119:75-9. [DOI:10.1016/j.clineuro.2014.01.020] [PMID]
11. Cheng R, Tian H, Gao W, Li Z. A comparison between endoscopic transsphenoidal surgery and traditional trans-sphenoidal microsurgery for functioning pituitary adenomas. Journal of International Medical Research. 2011;39(5):1985-93. [DOI:10.1177/147323001103900545] [PMID]
12. Jankowski PP, Crawford JR, Khanna P, Malicki DM, Ciacci JD, Levy ML. Pituitary tumor apoplexy in adolescents. World neurosurgery. 2015;83(4):644-51. [DOI:10.1016/j.wneu.2014.12.026] [PMID]
13. Storr HL, Alexandraki KI, Martin L, Isidori AM, Kaltsas G, Monson JP, et al. Comparisons in the epidemiology, diagnostic features and cure rate by transsphenoidal surgery between paediatric and adult-onset Cushing's disease. European Journal of Endocrinology. 2011;164(5):667-74. [DOI:10.1530/EJE-10-1120] [PMID]
14. Rigante M, Massimi L, Parrilla C, Galli J, Caldarelli M, Di Rocco C, et al. Endoscopic transsphenoidal approach versus microscopic approach in children. International journal of pediatric otorhinolaryngology. 2011;75(9):1132-6. [DOI:10.1016/j.ijporl.2011.06.004] [PMID]
15. Hofstetter CP, Nanaszko MJ, Mubita LL, Tsiouris J, Anand VK, Schwartz TH. Volumetric classification of pituitary macroadenomas predicts outcome and morbidity following endoscopic endonasal transsphenoidal surgery. Pituitary. 2012;15(3):450-63. [DOI:10.1007/s11102-011-0350-z] [PMID]
16. Shin SS, Gardner PA, Stefko ST, Madhok R, Fernandez-Miranda JC, Snyderman CH. Endoscopic endonasal approach for nonvestibular schwannomas. Neurosurgery. 2011;69(5):1046-57. [PMID]
17. Locatelli D, Massimi L, Rigante M, Custodi V, Paludetti G, Castelnuovo P, et al. Endoscopic endonasal transsphenoidal surgery for sellar tumors in children. International journal of pediatric otorhinolaryngology. 2010;74(11):1298-302. [DOI:10.1016/j.ijporl.2010.08.009] [PMID]
18. Sughrue ME, Chang EF, Tyrell JB, Kunwar S, Wilson CB, Blevins Jr LS. Pre-operative dopamine agonist therapy improves post-operative tumor control following prolactinoma resection. Pituitary. 2009;12(3):158-64. [DOI:10.1007/s11102-008-0135-1] [PMID]
19. Ammirati M, Wei L, Ciric I. Short-term outcome of endoscopic versus microscopic pituitary adenoma surgery: a systematic review and meta-analysis. Journal of Neurology, Neurosurgery & Psychiatry. 2012:jnnp-2012-303194.
20. Chone CT, Sampaio MH, Sakano E, Paschoal JR, Garnes HM, Queiroz L, et al. Endoscopic endonasal transsphenoidal resection of pituitary adenomas: preliminary evaluation of consecutive cases. Brazilian journal of otorhinolaryngology. 2014;80(2):146-51. [DOI:10.5935/1808-8694.20140030] [PMID]

Add your comments about this article : Your username or Email:
CAPTCHA code

© 2018 All Rights Reserved | Iranian Journal of Neurosurgery

Designed & Developed by : Yektaweb