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Intrasellar pressure is related to endocrine disturbances in patients with pituitary tumors
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.ORCID iD: 0000-0002-6471-9503
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.
Department of Surgical Sciences, Otorhinolaryngology, Uppsala University, Uppsala, Sweden.
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2023 (English)In: World Neurosurgery, ISSN 1878-8750, E-ISSN 1878-8769, Vol. 175, p. e344-e351Article in journal (Refereed) Published
Abstract [en]

Objective: The 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.

Methods: The 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.

Results: The 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.

Conclusions: In 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.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 175, p. e344-e351
Keywords [en]
Hyperprolactinemia, Hypopituitarism, Intrasellar pressure, Pituitary adenoma
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:umu:diva-206954DOI: 10.1016/j.wneu.2023.03.085PubMedID: 36966914Scopus ID: 2-s2.0-85152366491OAI: oai:DiVA.org:umu-206954DiVA, id: diva2:1753360
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Umeå UniversityRegion VästerbottenAvailable from: 2023-04-26 Created: 2023-04-26 Last updated: 2023-07-13Bibliographically approved

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Simander, GabrielDahlqvist, PerLindvall, PeterKoskinen, Lars-Owe D.

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CiteExportLink to record
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