Resumen

CAMPERO, Álvaro. Macroadenomas de hipófisis con extensión supraselar: resultados quirúrgicos en 26 casos operados por vía endonasal transesfenoidal. Rev. argent. neurocir. [online]. 2007, vol.21, n.1. ISSN 1850-1532.

Objective: To evaluate the results of the endonasal transsphenoidal approach (ETA) for the treatment of pituitary tumors with suprasellar extension. Method: From January 2004 to December 2006, 26 adult patients (17 female, 9 male- mean age: 53.19 years) with pituitary macroadenomas and suprasellar extension (22 nonfunctioning, 5 acromegaly and 1 prolactinoma) were operated by a ETA. Hardy's classification was used to divide the tumors: 6 were grade A, 14 grade B, 5 grade C, and 1 grade D. All were symptomatic: 16 had visual symptoms, 3 endocrine, 5 visual and endocrine and 2 miscellaneous. Results: In 20 cases resection was total and in 6 cases resection was subtotal. The average surgical time was 116.54' (range: 90'-150'). All patients with visual deficits improved after surgery; 2 patients presented postoperative diabetes insipidus that disappeared after 2 weeks. After one month of surgery only 5 patients required substitutive hydrocortisone. Nine women were in fertile age, 6 of them began to menstruate and 1 became pregnant. Two men showed sexual impotence and infertility before surgery; both improved after surgery. Conclusion. ETA was an effective procedure to treat pituitary macroadenomas with suprasellar extension and had a low rate of complications.

Palabras clave : Endonasal transsphenoidal approach; Pituitary adenoma; Suprasellar extension.

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