Department of Neurosurgery, Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, USA. Electronic address: https://twitter.com/@oliverytang.
Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, 90 Bergen Street Room, Suite 8100, Newark, NJ 07101, USA; Department of Neurological Surgery, Rutgers New Jersey Medical School, 90 Bergen Street Room, Suite 8100, Newark, NJ 07101, USA.
Otolaryngol Clin North Am. 2022 Apr;55(2):351-379. doi: 10.1016/j.otc.2021.12.008.
Giant pituitary adenomas (GPAs) comprise 5% to 15% of pituitary adenomas, but have higher rates of extrasellar invasion, subtotal resection, surgical morbidity, and recurrence. With the possible exception of giant prolactinomas, GPAs require surgical decompression. On review of 3 decades of case series encompassing 699 microsurgical transsphenoidal (MT), 1060 endoscopic endonasal trans-sphenoidal (EET), and 513 transcranial (TC) patients, gross total resection and recurrence rates were comparable across modalities, but the EET approach had lower perioperative mortality and superior restoration of visual function. Each approach has unique indications. Combined EET-TC approaches for minimizing residual tumor represent another area of study.
巨大垂体腺瘤（GPAs）占垂体腺瘤的 5%至 15%，但具有更高的鞍外侵犯、次全切除、手术发病率和复发率。除了巨大泌乳素瘤之外，GPAs 需要手术减压。对涵盖 699 例显微镜下经蝶窦（MT）、1060 例内镜经鼻蝶窦（EET）和 513 例经颅（TC）患者的 30 年病例系列回顾显示，各种方法的大体全切除率和复发率相当，但 EET 方法的围手术期死亡率较低，视觉功能恢复更好。每种方法都有其独特的适应证。联合 EET-TC 方法以最大限度地减少残留肿瘤是另一个研究领域。
