Kadashev B.A., Trunin Ju. K., Kalinin P.L., Alexeev S.N., Shkarubo A.N., Sokolov A.F., Grigoriev A.J.,
11th European congress of neurosurgery (EANS), Copengagen, Denmark 19-24, September, 1999.
(Burdenko Neurosurgical Institute, Moscow, Russia)
For the period from 1988 to 1998 we operated about 2300 patients. The saved experience allows to formulate the indications to different types of operations at pituitary adenomas (РА) with ехtrasellar growth.
We performed transcranial operations at PA with multicentral or asymmetrical intracranial growth or expressed invasion into cavernosis sinus or ventricular system.
Indications for operating by a transnasal approach were determined in presence outgrowing into the skull base, switching cavernosis sinus invasion. Shot-term controlled intracranial hypertension used in patients with large and giants suprasellar symmetrical growth for tumor’s capsule dislocation to the turkey saddle. We perfomed endoscopy for the control of the radical removal of PA.
Two-staged operations performed at PA with expressed intracranial and scull base invasive in cases, when PA cannot be completely removed using transcranial or transnasal approach alone. The best results were achieved by using transcranial operations as the first step of two-staged treatment (recommended interval between transcranial and transnasal operations is 3-5 months).