[Complications of the direct endonasal transsphenoidal approach in the management of pituitary adenomas].

OBJECTIVE

To describe the frequency of complications and complaints caused by direct endonasal transsphenoidal approach used in the resection of pituitary adenomas.

PATIENTS AND METHODS

In a retrospective way, we review patients' records with pituitary adenomas, operated by means of direct endonasal transsphenoidal approach, between August 2003 and December 2004. We recollected information about operative and postoperative complications, besides complaints registered in patients' records.

RESULTS

41 patients were included, 23 (56.1%) males and 18 (43.9%) females, with a mean age of 47.7 -/+16.8 years. Operative complications were intrasellar hemorrhage in three patients (7.3%), hypertension in two (4.9%) and cerebrospinal fluid fistula in one (2.4%). On the other hand, postoperative complications were diabetes insipidus (24.4%) in ten cases, anterior pituitary insufficiency (4.9%) in two and sinusitis (2.4%) in one. Nasal congestion was the most common complaint (31.7%) in thirteen patients.

CONCLUSIONS

Supported in our results, the direct endonasal transsphenoidal approach tends to present mainly fewer nasal complications and complaints, and in the future it could be considered like the preferred approach for resection of pituitary adenomas.