Pituitary adenoma is a common benign intracranial tumor with a general population incidence of 1 per 100,000. Its incidence is second only to glioma and meningioma among intracranial tumors, accounting for about 10% of intracranial tumors, and has been increasing in recent years. Pituitary adenomas can directly cause a series of metabolic disorders and organ damage due to overproduction of pituitary hormones, and can also cause serious impairment of corresponding functions by pressing some important structures through occupational effects. Treatment of pituitary adenomas is generally based on surgery, supplemented by radiation and medication. Medication alone, radiotherapy is not effective.
The pituitary gland, located below the brain, is as large as a pea and shaped like one. It secretes hormones that act both directly on the body and also stimulate other glands to produce hormones, or adjust the hormone production of other glands, and indirectly on various tissues.
Clinical manifestations of pituitary tumor: 1. Endocrine hyperfunction signs: Endocrine hyperfunction signs can appear in the early stage of microadenoma. As the adenoma grows and develops, it may compress and erode the pituitary tissue and its pituitary gland and periportal structures, resulting in endocrine hypofunction, visual dysfunction and other cranial nerve and brain symptoms.
2.Headache: About 2/3 of patients have headache in early stage, mainly located in retro-orbital area, forehead and double frontal area, with light degree and intermittent attacks.
3.Visual field disorder: As the tumor grows up, about 60%-80% of the cases can be compressed in different parts of the visual pathway, resulting in different visual dysfunction, typical cases are bi-temporal hemianopia, and severe visual impairment is caused by advanced tumor optic nerve atrophy.
4. Other neurological and brain damage: if the tumor develops posteriorly and presses the pituitary stalk and hypothalamus, it may cause uveitis and hypothalamic dysfunction; if it extends to the frontal lobe anteriorly, it may cause psychiatric symptoms, epilepsy and olfactory disorder; if it invades the cavernous sinus laterally, it may cause multiple cranial nerve paralysis; if it grows backward into the interpeduncular pool and slope and presses the brain stem, it may cause crossed paralysis and coma. Downward protrusion into the pterygoid sinus, nasal cavity and nasopharynx may result in epistaxis, cerebrospinal fluid leakage and complications of intracranial infection.
Treatment of pituitary adenoma: The treatment of pituitary adenoma is generally based on surgery, supplemented by radiation and drug therapy, and simple drug therapy, radiotherapy is not ideal. Surgical treatment is successively after transcranial and transsphenoidal surgical approaches. Nowadays, with the development of neurosurgery and its progress, transsphenoidal resection of pituitary adenoma has been widely used in clinical practice. The transnasal butterfly approach for pituitary adenoma has the advantages of short operation time, little damage to the patient, no impact on the appearance by using the natural nasal passage, quick recovery of the patient, who can get out of bed in three days and be discharged in about ten days, low hospitalization cost and few complications, etc., and has become the preferred treatment for pituitary adenoma. Our hospital now routinely performs transsphenoidal pituitary tumor resection, and has cured dozens of patients with good results.