Endoscopic Endonasal Approach to the GH Secreting Pituitary Adenomas: endocrinological outcome in 68 patients
Endoscopic Endonasal Approach to the GH Secreting Pituitary Adenomas: endocrinological outcome in 68 patients
Mehdi Zeinalizadeh,M.D
Mohamad Taghvaei,M.D
Department of Neurological Surgery,
J.Behjati,M.D
M.Nakhjavani, M.D
Dpartment of Endocrinology and Metabolism
Seyed M. Sadrhoseini,M.D
Department of Otolaryngology,Head, and Neck Surgery,
Imam Khomeini Hospital Complex,
Tehran University of Medical Sciences, Tehran, Iran
- Nowadays, the endoscopic trans-sphenoidal approach has become an initial option for resection of all pituitary adenomas because of having a lot of advantages:
- Better illumination
- Improved visualization
- Less nasal trauma
- Increased patient comfort
- Using angle scopes to reach the parasellar region
- Achieving better results on tumor removal
- 2000 criteria:
Normal IGF-I level and a nadir GH less than 1 ng/mL during oral glucose tolerance testing (OGTT) or a random GH of less than 2.5 ng/mL
- 2010 criteria:
A normal IGF-I level and minimum GH to less than 0.4 ng/mL during OGTT or a random GH of less than 1.0 ng/mL
- Inclusion criteria for the prospective study included 68 patients undergoing for acromegaly From July, 2013 to July, 2016.
- Patients were considered to have attained biochemical remission if their IGF-I level was normal and either their GH nadir was less than 0.4 ng/mL during an OGTT or their random GH was less than 1.0 within at least 3 months of surgery.
- Hormonal analyses repeated 6, 9 and 12 month and then yearly after surgery.
- In cases where the cavernous sinus is thought to be invaded (Knosp Scores 3, 4), a more lateral extension exposing the anterior wall of the cavernous was achieved carefully.
