Evaluation of the transcranial approach to pituitary adenomas based on quantitative analysis of pre- and postoperative visual function.

Over a 16-year period, 105 patients with pituitary adenoma accompanied by visual disturbance underwent transcranial intracapsular removal of the tumor followed by radiotherapy. Postoperative recovery of visual function in these patients was compared with the results obtained in other institutions after trans-sphenoidal surgery. The severity of preoperative visual impairment was correlated with the duration of visual impairment, the degree of optic atrophy, the extent of suprasellar tumor infiltration, and age. Trans-sphenoidal surgery appears more effective in patients with mild preoperative visual disturbance, whereas the transcranial approach yields better results in patients with moderate to severe preoperative visual deficits.