January - March 2025, Volume 21, Issue 1

Repschlaeger M, Binder V, Zhao Y, Fahlbusch R, Buchfelder M

Endocrine Disturbances in Parasellar Meningiomas and the Effect of Transsphenoidal Decompression Operations

Acta Endo (Buc) 2025, 21 (1): 67-73
doi: 10.4183/aeb.2025.67

Objective. To assess the outcome of clinical and endocrinological dysfunctions after transsphenoidal decompression in parasellar meningioma. Methods. Retrospective pre- and postoperative evaluation of 40 patients (30 women, 10 men; mean age, 55.9±11.9) who underwent decompressive transsphenoidal microsurgeries. The preoperative investigation took place one month prior surgery, the first follow-up within one week, the second follow-up within three months postoperatively. Results. The most common symptom in our study was diplopia (47.5%, n=19) which showed improvement in 21.1% (n=4) of cases. Preoperative hyperprolactinemia, presented in 52.5% of patients (n=21) with hyperprolactinemia remaining in just 20% of patients (n=8) in the first follow-up. Other endocrine axes were affected less frequently, but also majorly showed improvements. The corticotropic axis was affected in 8.8% (n=3) and remained unchanged. Female gonadotropic axis irritation decreased from 34.5% (n=10) to 31.0% (n=9), male axis deterioration improved in two cases from 50% (n=5) to 30% (n=3). The somatotropic and thyrotropic axes were never negatively affected. Adjuvant radiotherapy was carried out in 60% (n=24) of patients and not yet commenced in an additional nine (22.5%). Conclusion. Experience shows that transsphenoidal decompression is a useful and low complication associated procedure in the initial management of cavernous sinus meningioma.

Keywords: Cavernous sinus, Meningioma, Parasellar tumour, Transsphenoidal surgery, Pituitary tumour, Hypopituitarism

Correspondence: Prof. Michael Buchfelder, Erlangen University Hospital, Neurosurgery, Schwabachanlage 6, Erlangen, 91054,Germany, E-mail: michael.buchfelder@fau.de