Pituitary macroadenomas are adenomas with a diameter greater than 10mm, and the main surgical procedure is transsphenoidal approach; the main risks and complications are intra-saddle complications, complications caused by the operation on the saddle, complications within the approach and pterygoid sinus, and endocrine symptoms.
1. Intersaddle complications: internal carotid artery injury, pseudoaneurysm, cavernous sinus fistula of internal carotid artery, postoperative vasospasm and occlusion of large vessels; cerebral nerve injury is also seen, of which abducens nerve injury is most common.
2. Complications caused by saddle operation: it can lead to hypothalamus, pituitary stalk, pituitary gland injury; optic nerve, optic cross and peripheral vascular injury leading to vision loss or blindness. Saddle diaphragm and arachnoid injury rupture leads to cerebrospinal fluid leakage, which can cause pneumocranium, meningitis, and other subarachnoid hemorrhage, bilateral epidural hematoma and so on.
3. Complications occurring in the access and pterygoid sinus: perforation of the nasal septum, numbness of the upper lip and teeth, nasal deformity, fracture of the maxilla, orbital bone, sieve bone and so on, pterygoid sinusitis and abscess and so on.
4. Endocrine symptoms: patients may have uremia, mostly transient; the incidence of postoperative pituitary function decline is 1%-10%, most of which are preoperative hypopituitarism of macroadenomas.
Patients who have been diagnosed with pituitary adenoma should go to the relevant departments of regular hospitals in time, so as to avoid the delay of the condition and the adverse consequences.