Predictors of diabetes insipidus post-hypophysectomy

Transient diabetes insipidus (DI) after pituitary surgery is not uncommon and its diagnosis fairly obvious. Permanent DI is rare and often depends on the neurosurgeon’s experience. This retrospective study describes a large series of patients with majority undergoing endoscopic transsphenoidal...

Olfactory protective effect of omega-3 supplements during healing after endoscopic sellar and parasellar resection

This multicentre study, led by researchers from Stanford, demonstrates another use for omega-3 supplements. The study analysed cohorts equally divided between control arm and omega-3 supplementation. Post endoscopic sellar and parasellar resection, better olfactory function was observed at three and...

Prolactinomas: when to operate

Prolactinomas are the most common functional pituitary adenomas, comprising 40% of all pituitary adenomas. There are consensus guidelines and several common management pathways. This article discusses the role of surgery for these patients. Following diagnosis, the goals of treatment are...

3D endoscopy in pituitary adenoma surgery

Endoscopic approach for pituitary adenoma surgery is well recognised. There has been recent refinement of 3D endoscopy technology which improves on the depth of vision offered and more compact delivery. This may improve visualisation of the critical structures involved in...

Paediatric versus adult pituitary adenomas

This retrospective study compares paediatric with adult patients undergoing pituitary adenoma surgery over a period of 26 years at a single institution. All surgeries were performed via a sublabial approach using the operating microscope. An endoscope was used occasionally for...

Recovery room cortisol to predict long-term glucocorticoid supplementation

The authors report the results of using recovery room (RR) cortisol to predict the need for long-term glucocorticoids in patients who underwent transsphenoidal surgery (TSS). They conducted a retrospective study of preoperative morning serum cortisol (MSC), RR cortisol and day...

Close monitoring of patients for delayed hyponatremia post-transsphenoidal surgery

he incidence of delayed hyponatremia is 16-28% and usually accounts for unplanned readmission of the patient within 30 days after transsphenoidal surgery. One of the surrogate measures of quality of care adopted by the government and regulatory agencies is 30-day...

Intraoperative MRI use during pituitary tumour resection

This article provides an overview of intraoperative MRI (iMRI) use in transphenoidal surgery (TSS) for pituitary tumours. Traditionally imaging of the surgical field during surgery involves intraoperative fluoroscopic imaging or neuronavigation which help to avoid injury to critical structures but...

Prioritisation of surgery for pituitary tumours

This study is based on the findings of internationally renowned skull base surgeons who convened to recommend this stratification scheme. The study authors report that incidental diagnosis of pituitary tumours during routine imaging as well as early identification of visual...

The increasingly favourable outcomes from endoscopic endonasal approaches for the management of pituitary adenomas

Historically, pituitary tumours have been surgically managed with an open, transcranial approach. Although this approach still has its merits in large intracranial adenomas, technological advancement has allowed smaller tumours to be debulked via a transseptal microscopic technique. These days, the...