Causes and treatment of acute visual dysfunction after transsphenoidal surgery of pituitary adenoma

Abstract

Visual dysfunction is a sever complication of transsphenoidal surgery of pituitary adenoma. In this study, we explored the mechanisms and strategies of prevention and treatment of early acute visual deterioration after transsphenoidal surgery for removal of pituitary adenoma. Clinical data of 12 patients with transsphenoidal pituitary adenoma resection of early postoperative acute visual deterioration were analyzed retrospectively. All the cases were come from Peking Union Medical College Hospital during Jan 1991 to May 2014. Among 12 cases, 8 were with intrasellar haematoma, 2 with suprasellar haematoma, 2 with vascular spasm. After all these treatments, good recovery achieved in 10 cases, not so well in 1 with rupture of intracranial aneurysm, and 1 case death with suprasellar haematoma and intracranial infection. Blood circulation variation of the optic nerve and optic chiasma could be caused by long-term compressing with the pituitary adenoma, on this basis, combined with the intrasellar haematoma, direct injury during the operation, and acute ischemia of the optic chiasma and tamping too tight in the sella turcica, etc, resulting in acute visual function disorder after pituitary adenomas transsphenoidal surgery, find the reason and early treatment can be effective to save the patient's visual acuity.