Abstract
Although complications of transseptosphenoidal (TSS) pituitary surgery have been discussed
in the literature, there has not been an analysis of complication rates related to
clinical features and the nature of the tumor. A retrospective review of 366 TSS procedures
(354 patients) for excision of pituitary adenomas evaluated the incidence and management
of perioperative complications. The mortality rate was 0.82%. The most frequently
encountered complications were transient diabetes insipidus (8.74%) and cerebrospinal
fluid (CSF) rhinorrhea (4.10%). Other complications included exacerbation of visual
acuity and visual field defects, hemorrhage, hydrocephalus, and meningitis. The factors
evaluated were gender, age, tumor size, hormone secretory status, and any history
of prior pituitary surgery.
There was a significantly higher incidence of transient diabetes insipidus in patients
with hormone-secreting tumors. Minor and total complication rates were significantly
increased in microadenomas, hormone-secreting tumors, in female patients, and in patients
less than 60 years of age reflecting the increased incidence of transient diabetes
insipidus in young female patients with hormone-secreting tumors. Observed intraoperative
CSF leaks predisposed to postoperative CSF rhinorrhea. There were no identifiable
risk factors for major complications.
