Post-Operative Visual Improvement in Pituitary Lesions after Trans-sphenoidal Surgery

Authors

  • Muhammad Irfan Department of Neurosurgery, King Edward Medical University
  • AMIR AZIZ Department of Neurosurgery
  • YASIR-UR- DIN Department of Neurosurgery
  • Muhammad Anwar Department of Neurosurgery
  • Kashif Siddique Department of Neurosurgery

Keywords:

Trans-sphenoidal, Pituitary tumors.

Abstract

The pituitary gland tumors are significant cause of endocrinopathies and visual field defects or decreased visual acuity. In pituitary macro-adenomas majority of the patients present with visual morbidity. These lesions may be clinically silent or may present with visual deterioration, hormonal disturbances and ocular palsies.
Objective: To study postoperative visual improvement after trans-sphenoidal excision of pituitary macro-adenomas.
Material and Methods: This was an interventional longitudinal study conducted in the department of Neuro-surgery, Lahore General Hospital Lahore affiliated with Postgraduate Medical Institute Lahore. Study comprises of 15 adult patients of both sexes harbouring functioning / non-functioning pituitary macro-adenoma having visual deficit presented to the department of neurosurgery, Lahore General Hospital, Lahore during the study period. Non-purposive sampling technique was used for sample selection by using a pre defined inclusion cri-teria. Visual acuity was measured by Snellen chart (Distant vision) Jaeger chart (Near vision) and base line was compared for improvement after surgery in terms of complete, partial, or no improvement. Post operative oph-thalmological examination were carried out on 1st post operative day, 1month, and 3 months of surgery, for to check improvement of vision and also improvement in visual field defects.
Results: Mean age in our study of 15 patients was 37.8 years. The youngest patient was 17 years and oldest was 68 years. Gender distribution shows that 8 patients were females and 7 were males. The size of the tumor was as of MRI report calculated in centimeters. Mean tumor size was 3.10 ± 0.52 cm. Significant improvement was seen in visual acuity in right side eyes where as no significant improvement was seen in visual acuity in left side eye of patients.
Conclusion: Our results suggest that the vast majority of challenging sellar tumors can still be resected safely, effectively, and efficiently with this approach and theoretical advantages of the approach are based on improved visualization and decreased tissue manipulation

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Published

2018-10-09

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Vol. 16 No. 2 (2012): July-December

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Original Articles

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