Introduction
Methods
Visual outcome
Quality of life
Olfactory function
Surgical procedures
Transcranial approach
Endoscopic endonasal transtuberculum-transplanum approach
Statistical analyses
Results
Patient cohort
Total | Group transcranial | Group endonasal | p value | ||||
---|---|---|---|---|---|---|---|
n count | n count | % | n count | % | |||
No. of patients | 30 | 13 | 43 | 17 | 57 | ||
Age (years) | Mean | 41 | 31.2 | 48.5 | 0.04 | ||
Range | (1 … 84) | (1 … 61) | (12 … 84) | ||||
Female | 16 | 8 | 62 | 8 | 47 | NS | |
Male | 14 | 5 | 38 | 9 | 53 | NS | |
Pediatric patients | 4 | 3 | 23 | 1 | 6 | NS | |
Initial diagnosis | 28 | 12 | 92 | 16 | 94 | NS | |
Follow-up | Mean (months) | 136 | 56 | 0.002 | |||
Range | (34 … 202) | (12 … 145) | |||||
Lost-to | 6 | 3 | 23 | 3 | 18 | NS | |
Repeat surgery | Total | 4 | 2 | 15 | 2 | 12 | NS |
Transcranial | 4 | 2 | 2 | ||||
Endonasal | 0 | 0 | 0 | ||||
Adjuvant radiation | All indications | 8 | 2 | 15 | 6 | 35.3 | NS |
After STR | 5 | 1 | 4 | ||||
Tumor recurrence | 3 | 1 | 2 |
Surgical procedures
Total | Group transcranial | Group endonasal | p value | ||||
---|---|---|---|---|---|---|---|
n count | n count | % | n count | % | |||
EOR | GTR | 17 | 7 | 54 | 10 | 59 | NS |
STR | 8 | 5 | 38 | 3 | 18 | NS | |
Partial | 5 | 1 | 8 | 4 | 23 | NS | |
Stalk preservation | 18 | 5 | 39 | 13 | 76 | 0.06 | |
Complications | All | 17 | 5 | 39 | 11 | 65 | 0.14 |
CSF leak | 7 | 2 | 15 | 5 | 29 | NS | |
Perioperative death | 1 | 1 | 8 | 0 | 0 | NS | |
Meningitis | 2 | 0 | 0 | 2 | 12 | NS | |
Hydrocephalus | 2 | 0 | 0 | 2 | 12 | NS | |
Other | 4 | 2 | 15 | 2 | 12 | NS |
Perioperative complications
Ophthalmological outcome
Visual acuity
Group transcranial | Group endonasal | p value | ||||
---|---|---|---|---|---|---|
n count | % | n count | % | |||
Visual acuity | ||||||
Pre-OP | Impairment (eyes) | 11 | 42 | 11 | 39 | NS |
logMAR left eye | 0.1 | 0.1 | NS | |||
logMAR right eye | 0.1 | 0.2 | NS | |||
Post-OP | Improved to pre-OP | 5 | 45 | 10 | 91 | 0.02 |
Deteriorated to pre-OP | 0 | 0 | 1 | 9 | NS | |
Lost to follow-up | 2 | 8 | 0 | 0 | NS | |
logMAR left eye | 0.1 | 0.1 | NS | |||
logMAR right eye | 0.1 | 0.1 | NS | |||
Follow-up | Improved to pre-OP | 7 | 64 | 10 | 91 | NS |
Deteriorated to pre-OP | 2 | 18 | 1 | 9 | NS | |
Lost to follow-up | 10 | 38 | 2 | 7 | 0.008 | |
logMAR left eye | 0 | 0 | 0.1 | NS | ||
logMAR right eye | 0.05 | 0 | NS | |||
Visual field | ||||||
Pre-OP | Impairment (eyes) | 16 | 62 | 15 | 54 | NS |
Visual field score left eye | 5 | 5,5 | NS | |||
Visual field score right eye | 4 | 4 | NS | |||
Post-OP | Improved to pre-OP | 2 | 8 | 10 | 36 | 0.02 |
Deteriorated to pre-OP | 2 | 8 | 0 | 0 | NS | |
Lost to follow-up | 2 | 8 | 0 | 0 | NS | |
Visual field score left eye | 4,5 | 6 | 0.01 | |||
Visual field score right eye | 4 | 6 | 0.06 | |||
Follow-up | Improved to pre-OP | 5 | 31 | 13 | 50 | NS |
Deteriorated to pre-OP | 2 | 12 | 0 | 0 | 0.14 | |
Lost to follow-up | 10 | 38 | 2 | 7 | 0.008 | |
Visual field score left eye | 6 | 6 | NS | |||
Visual field score right eye | 6 | 6 | NS |
Visual field
Pituitary function
Group transcranial | Group endonasal | p value | ||||
---|---|---|---|---|---|---|
n count | % | n count | % | |||
Preoperative | Adrenocorticotrope | 6 | 46 | 4 | 24 | NS |
Thyreotrope | 7 | 54 | 6 | 35 | NS | |
Somatotrope | 3 | 23 | 8 | 47 | NS | |
Gonadotrope | 5 | 38 | 7 | 41 | NS | |
Diabetes insipidus | 2 | 15 | 4 | 24 | NS | |
Postoperative | Adrenocorticotrope | 12 | 92 | 11 | 65 | 0.1 |
Thyreotrope | 12 | 92 | 9 | 53 | 0.04 | |
Somatotrope | 9 | 69 | 11 | 65 | NS | |
Gonadotrope | 11 | 85 | 10 | 59 | NS | |
Diabetes insipidus | 8 | 62 | 9 | 53 | NS | |
Lost to follow-up | 1 | 7 | 0 | 0 | NS | |
Long-term follow-up | Adrenocorticotrope | 9 | 69 | 9 | 53 | NS |
Thyreotrope | 9 | 69 | 5 | 29 | 0.06 | |
Somatotrope | 10 | 77 | 12 | 71 | NS | |
Gonadotrope | 10 | 77 | 11 | 65 | NS | |
Diabetes insipidus | 8 | 62 | 7 | 41 | NS | |
Lost to follow-up | 3 | 23 | 3 | 18 | NS |
Visual acuity | Visual field deficits | Body mass index | Pituitary function (impaired axes) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
logMAR left | logMAR right | VFD-score left | VFD-score right | Adreno | Thyreo | Somato | Gonado | Diab. Ins. | |||
Transcranial | Pre-OP | 0.1 | 0.1 | 5 | 4 | 24.6 | 6 | 7 | 3 | 5 | 2 |
Post-OP | 0.1 | 0.1 | 4.5 | 4 | 12 | 12 | 9 | 11 | 8 | ||
Follow-up | 0 | 0.05 | 6 | 6 | 35.1 | 9 | 9 | 10 | 10 | 8 | |
p value pre vs. post | NS | NS | NS | NS | 0.005 | 0.01 | 0.01 | 0.02 | 0.01 | ||
p value pre vs. FU | NS | NS | 0.15 | NS | 0.008 | 0.07 | 0.08 | 0.0004 | 0.003 | 0.003 | |
Endonasal | Pre-OP | 0.1 | 0.2 | 5,5 | 4 | 26.5 | 4 | 6 | 8 | 7 | 4 |
Post-OP | 0.1 | 0.1 | 6 | 6 | 11 | 9 | 11 | 10 | 9 | ||
Follow-up | 0.1 | 0 | 6 | 6 | 29.8 | 9 | 5 | 12 | 11 | 7 | |
p value pre vs. post | NS | NS | 0.04 | 0.12 | 0.04 | NS | NS | NS | 0.12 | ||
p value pre vs. FU | NS | 0.01 | 0.01 | 0.03 | 0.14 | 0.03 | NS | 0.06 | 0.07 | 0.15 |
Quality of life
Working status
Body mass index
ASBQ test
SNOT
Olfactory function
Group T | Group E | p value | ||
---|---|---|---|---|
n count | n count | |||
Long-term follow-up | ||||
Working status | Full-time worker | 2 | 7 | 0.1 |
ASBQ | (Median score) | 3.9 | 4.6 | 0.14 |
SNOT-22 | (Median score) | 17 | 7 | NS |
Body mass index | (Mean) | 35.1 | 29.8 | 0.05 |
Olfaction | Left side | 7 | 9 | NS |
Right side | 7 | 8 | NS |