ENDOCRINE DISTURBANCES IN PARASELLAR MENINGIOMAS AND THE EFFECT OF TRANSSPHENOIDAL DECOMPRESSION OPERATIONS.

OBJECTIVE

To assess the outcome of clinical and endocrinological dysfunctions after transsphenoidal decompression in parasellar meningioma.

METHODS

Retrospective pre- and postoperative evaluation of 40 patients (30 women, 10 men; mean age, 55.9±11.9) who underwent decompressive transsphenoidal microsurgeries. The preoperative investigation took place one month prior surgery, the first follow-up within one week, the second follow-up within three months postoperatively.

RESULTS

The most common symptom in our study was diplopia (47.5%, n=19) which showed improvement in 21.1% (n=4) of cases. Preoperative hyperprolactinemia, presented in 52.5% of patients (n=21) with hyperprolactinemia remaining in just 20% of patients (n=8) in the first follow-up. Other endocrine axes were affected less frequently, but also majorly showed improvements. The corticotropic axis was affected in 8.8% (n=3) and remained unchanged. Female gonadotropic axis irritation decreased from 34.5% (n=10) to 31.0% (n=9), male axis deterioration improved in two cases from 50% (n=5) to 30% (n=3). The somatotropic and thyrotropic axes were never negatively affected. Adjuvant radiotherapy was carried out in 60% (n=24) of patients and not yet commenced in an additional nine (22.5%).

CONCLUSION

Experience shows that transsphenoidal decompression is a useful and low complication associated procedure in the initial management of cavernous sinus meningioma.