프로락틴 분비 뇌하수체 종양 절제술에 있어 내시경하 경비강 경접형동 접근법의 결과
Results of Endoscopic Transnasal Transsphenoidal Treatment of Prolactin Secreting Pituitary Adenoma
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The endoscopic transnasal transsphenoidal approach is a common approach for pituitary tumor. The objectives of our study is to report indication, efficacy, safety and endocrine result of endoscopic transnasal transsphenoidal surgery in patients with prolactin secreting pituitary adenoma. Subjects and Method：We retrospectively reviewed the medical records of 10 patients who had received endoscopic transnasal transsphenoidal pituitary surgery of prolactin secreting pituitary adenoma. Results：Three patients were resistant and intolerant in medical therapy. Visual symptoms were developed in 8 patients. Postoperatively, 4 patients (40%) achieved normalization of prolactin and relief of symptoms from endoscopic surgery alone. Four of the remaining 6 patients achieved postoperative normalization of prolactin with medication. Visual symptom was improved in all patients. One patient had postoperative diabetes insipidus. Conclusion：We believe that the endoscopic method is a safe, hardly invasive and efficient surgical technique in prolactinoma. Medical treatment with dopamine agonist drugs is the mainstay of treatment and endoscopic surgery will be used in cases of drug resistance, intolerance and development of acute visual symptom, we may offer endoscopic surgery as a viable treatment option. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:429-34)
Abstract
The endoscopic transnasal transsphenoidal approach is a common approach for pituitary tumor. The objectives of our study is to report indication, efficacy, safety and endocrine result of endoscopic transnasal transsphenoidal surgery in patients with prolactin secreting pituitary adenoma. Subjects and Method：We retrospectively reviewed the medical records of 10 patients who had received endoscopic transnasal transsphenoidal pituitary surgery of prolactin secreting pituitary adenoma. Results：Three patients were resistant and intolerant in medical therapy. Visual symptoms were developed in 8 patients. Postoperatively, 4 patients (40%) achieved normalization of prolactin and relief of symptoms from endoscopic surgery alone. Four of the remaining 6 patients achieved postoperative normalization of prolactin with medication. Visual symptom was improved in all patients. One patient had postoperative diabetes insipidus. Conclusion：We believe that the endoscopic method is a safe, hardly invasive and efficient surgical technique in prolactinoma. Medical treatment with dopamine agonist drugs is the mainstay of treatment and endoscopic surgery will be used in cases of drug resistance, intolerance and development of acute visual symptom, we may offer endoscopic surgery as a viable treatment option. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:429-34)
참고문헌 (17)
- Mindermann T, "Age-related and gender-related occurance of pituitary adenomas", Clin Endocrinol, 41(3), pp.359~364 (1994)
- Colao A, "Treatment of prolactinomas", Ann Med, 30(5), pp.452~459 (1998)
- Höfle G, "Surgery combined with dopamine agonists versus dopamine agonists alone in long-term treatment of macroprolactinoma: A retrospective study", Exp Clin Endocrinol Diabetes, 106(3), pp.211~216 (1998)
- Hamilton DK, "Surgical outcomes in hyporesponsive prolactinomas; Analysis of patients with resistance or intolerance to dopamine agonists", Pituitary, 8(1), pp.53~60 (2005)
- Sheehan MT, "Preminary comparison of the endoscopic transnasal vs the sublabial transseptal approach for clinically nonfunctioning pituitary macroadenomas", Mayo Clin Proc, 74(7), pp.661~670 (1999)
- Koren I, "Endoscopic transnasal transseptal microsurgery versus the sublabial approach for the treatment of pituitary tumors: Endonasal complications", Laryngoscope, 109(11), pp.1838~1840 (1999)
- Shah S, "Diabetes inspidus after pituitary surgery: Incidence after traditional versus endoscopic transsphenoidal approaches", Am J Rhinol, 15(6), pp.377~379 (2001)
- Kabil MS, "Fully endoscopic transnasal vs. transseptal transphenoidal pituitary surgery", Minim Ivasive Neurosurg, 48(6), pp.348~354 (2005)
- Webster J, "A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea", N Engl J Med, 331(14), pp.904~909 (1994)
- Corsello SM, "Giant prolactinomas in men: Efficacy of cabergoline treatment", Clin Endocrinol(oxf), 58(5), pp.662~670 (2003)
- Jankowski R, "Endoscopic pituitary tumor surgery", Laryngoscope, 102(2), pp.198~202 (1992)
- Gamea A, "The use of the rigid endoscope in trans-sphenoidal pituitary surgery", J Laryngol Otol, 108(1), pp.19~22 (1994)
- Jho HD, "Endoscopic endonasal transsphenoidal surgery: Experience with 50 patients", J Neurosurg, 87(1), pp.44~51 (1997)
- Nasseri SS, "A combined, minimally invasive transnasal approach to the sella turcica", Am J Rhinol, 12(6), pp.409~416 (1998)
- Sethi DS, "Endoscopic management of lesions of the sella turcica", J Laryngol Otol, 109(10), pp.956~962 (1995)
- Har-EL, "Endoscopic tananasal transsphenoidal Pituitary surgery comparison with the traditional sublabial transseptal approach", Otolaryngol Clin North Am, 38(4), pp.723~735 (2005)
- Wolfsberger S, "Microprolactinomas in males treated by transsphenoidal surgery", Acta Neurochir(Wien), 145(11), pp.935~941 (2003)