Surgical treatment of acute pituitary apoplexy through endoscopic endonasal transsphenoidal approach: report of 15 cases

Objective To discuss the operative techniques of endoscopic endonasal transsphenoidal surgery and perioperative management for treatment of acute pituitary apoplexy.Method From Mar.2004 to Mar.2011,15 patients were diagnosed as acute pituitary apoplexy.There were 4 male and 11 female( average age 39.0 years ).MRI scan,CT scan and endocrinological examinations were performed in all cases before operation.All patients were treated by endoscopic endonasal transsphenoidal operation.Glucocorticoids were used during perioperatve period.Results The tumors were totally removed in 12 cases and sub -totally removed in 3 cases,without operative death and serious complications.All patients were followed up from 6 to 36 months.Symptoms were improved in all cases and hormone replacement therapy was needed due to hypopituitarism.Conclusion The endoscopic endonasal transsphenoidal operation is safe and effective in treatment of acute pituitary apoplaxy.Appropriate perioperative management is important to the success of operation. Key words: Endoscopy;  Transsphenoidal surgery;  Pituitary apoplexy;  Pituitary adenoma