The Minimally Invasive Surgical Treatment Of Non-functioning Pituitary Adenomas In Elderly Patients

BACKGROUND AND OBJECTIVEAs the aging of population,the proportion of the population that is elderly is increasing.As a consequence, brain tumors of the elder people are now recognized with increasing frequency,including pituitary adenomas,of which the Non-functioning pituitary adenomas are the most common type. Because of the special group of Non-functioning pituitary adenomas,it’s different from the others groups in clinical characteristics and treatment.In this research,we focus on the clinical characteristics、treatment and follow-up and etc. We explore further in the study of Non-functioning pituitary adenomas statistical analysis hoping to improve the diagnosis and treatment of the Non-functioning pituitary adenomas.METHODS:With the help of retrospective analysis, We selected clinical data of23elderly patients over the age of60undergoing transsphenoidal surgery in212pituitary adenomas patients who we treated in Neurosurgery department of The Shandong Provincial Hospital GroupThe Eastern Hospital between20011-2013. RESULTS:We select23patients,of whic9male patients (60.9%) and12female patients were women (39.1).The age is60to74years,whose average is64.7years.The hospital stays range from3months to11years.19patients presented visual change and11patients presents defect of visual field,and5patients with headache,and2patients without any symptoms in the group of23patients.15cases is Macroadenma(1cm≤diameter<3cm),and8cases is Huge adenoma(diameter≥3cm).≤Turner diameter range from1.7cm to4.2cm,and average is3.4cm.After transsphenoidal surgery,4cases suffer from transient diabetes insipidus.Appropriate postoperative glucocorticoid supplementation was administered to all patients.7patients suffered from hypopituitarim and adminstrated hormone replacement therapy.80.0%patients with symptoms of headache and89.5%patients with the visual changes and45.5%patients with visual field loss improved significantly,No patients complained of permanent diabetes insipidus, post operative CSF-leak, postoperative bleeding or infection, or severe hypo-/hypernatremia.Every patient underwent clinical, biochemical and neuroradiological follow-up on a regular basis (average follow-up period of13.4months, ranging from6to24months)., of which3patients underwent gamma knife radiosurgery for the tumer regrowth.17patients’ visul improve and2get worse.3patients suffer from hypopituitarism and need long-term hormone replacement therapy. CONCLUSIONSNon-functioning pituitary adenomas in elderly patients mainly presents with visual defect and hypopituitarism,that may be overlooked for elderly patients’ endocrine feature.The size of the Non-functioning pituitary adenomas in elderly patients is mainly macroadenoma and huge adenoma when make a definite diagnosis.The elderly patients always coexist other diseases like Diabetes Mellitus and Hypertension,which increase the risk of Neurosurgery operation.Transsphenoidal surgery is the first choice to Non-functioning pituitary adenomas in elderly patients for its safety and effectiveness.Patient always recover well from surgery and do have no major post-operation complication.Radiotherapy is significantly to the pationts with tumer regrowth.Due to the possible injure to Intracranial structures the knife radiosurgery is recommended,instead of Conventional radiatherapy.