• World Neurosurg · Jul 2023

    Intrasellar pressure is related to endocrine disturbances in patients with pituitary tumours.

    • Gabriel Simander, Per Dahlqvist, Louise Oja, Per Olof Eriksson, Peter Lindvall, and KoskinenLars-Owe DLDDepartment of Clinical Science - Neurosciences, Umeå University, Umeå, Sweden..
    • Department of Clinical Science - Neurosciences, Umeå University, Umeå, Sweden. Electronic address: gabriel.simander@umu.se.
    • World Neurosurg. 2023 Jul 1; 175: e344e351e344-e351.

    ObjectiveThe aim of this study was to investigate the association between intraoperative intrasellar pressure (ISP) and pre- and postoperative endocrine disturbances with focus on hyperprolactinemia and hypopituitarism in patients with pituitary tumors.MethodsThe study is a consecutive, retrospective study with ISP collected prospectively. One hundred patients operated with transsphenoidal surgery due to a pituitary tumor, who had their ISP measured intraoperatively, were included. Data on patient endocrine status preoperatively and from 3-month postoperative follow-up were collected from medical records.ResultsThe risk of preoperative hyperprolactinemia in patients with nonprolactinoma pituitary tumors increased with ISP (unit odds ratio 1.067, n = 70) (P = 0.041). Preoperative hyperprolactinemia was normalized at 3 months after surgery. Mean ISP was higher in patients with preoperative thyroid-stimulating hormone (TSH) deficiency (25.3 ± 9.2 mmHg, n = 37) than in patients with intact thyroid axis (21.6 ± 7.2 mmHg, n = 50) (P = 0.041). No significant difference in ISP was found between patients with and without adrenocorticotropic hormone(ACTH) deficiency. No association was found between ISP and postoperative hypopituitarism at 3 months after surgery.ConclusionsIn patients with pituitary tumors, preoperative hypothyroidism and hyperprolactinemia may be associated with higher ISP. This is in line with the theory of pituitary stalk compression, suggested to be mediated by an elevated ISP. ISP does not predict the risk of postoperative hypopituitarism 3 months after surgical treatment.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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