{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:49:40Z","timestamp":1783774180285,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,9,27]],"date-time":"2014-09-27T00:00:00Z","timestamp":1411776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>This study aimed to determine the incidence of major complications following both primary and revision transsphenoidal pituitary surgery. Major complications included endocrinopathic, skull base, orbital, hemorrhagic and thromboembolic complications, respiratory failure, and death. Secondarily, this study aimed to examine factors associated with the occurrence of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort analysis of California and Florida all\u2010payer databases from 2005 to 2008.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The major complication rate following both primary and revision transsphenoidal pituitary surgery was calculated. Bivariate analyses were performed to investigate the relationship of patient characteristics with complication occurrence, and a multivariate model was constructed to determine risk factors associated with these complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 5,277 primary cases and 192 revision cases that met inclusion criteria. There was a nonsignificant absolute difference of 3.09% (95% confidence interval [CI]: \u221211.00 to 16.14) between the rate of complications following primary (n\u2009=\u2009443, 8.39%) and revision (n\u2009=\u200922, 11.46%) surgeries. Multivariate analyses showed that patients with Medicare (odds ratio [OR]:1.74, 95% CI: 1.17 to 2.61), Medicaid (OR: 2.13, 95% CI: 1.59 to 2.86), or a malignant neoplasm (OR: 3.10, 95% CI: 1.62 to 5.93) were more likely to have complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The rate of major complications following transsphenoidal pituitary surgery is lower than earlier retrospective reports. The overall complication rate following revision surgery was not significantly different from primary surgery. Insurance status and a diagnosis of a malignant neoplasm were associated with a higher rate of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2C <jats:italic>Laryngoscope<\/jats:italic>, 125:311\u2013317, 2015<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24892","type":"journal-article","created":{"date-parts":[[2014,9,27]],"date-time":"2014-09-27T08:25:03Z","timestamp":1411806303000},"page":"311-317","source":"Crossref","is-referenced-by-count":33,"title":["Complications following primary and revision transsphenoidal surgeries for pituitary tumors"],"prefix":"10.1002","volume":"125","author":[{"given":"James G.","family":"Krings","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Washington University School of Medicine Saint Louis Missouri"},{"name":"Stanford Medical Scholars Fellowship Stanford University School of Medicine Stanford California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorina","family":"Kallogjeri","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Washington University School of Medicine Saint Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Wineland","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Washington University School of Medicine Saint Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth G.","family":"Nepple","sequence":"additional","affiliation":[{"name":"Department of Urology University of Iowa School of Medicine Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay F.","family":"Piccirillo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Washington University School of Medicine Saint Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne E.","family":"Getz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Colorado School of Medicine Aurora Colorado U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,9,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20412"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-008-9107-z"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-011-0348-6"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-717X-6-167"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1042-3680(02)00031-1"},{"key":"e_1_2_6_7_1","first-page":"241","article-title":"Diagnosis and treatment of pituitary adenomas","volume":"29","author":"Chanson P","year":"2004","journal-title":"Minerva Endocrinol"},{"key":"e_1_2_6_8_1","first-page":"621","article-title":"Erfolreiche Operation eines Hypophysentumors auf nasalem Wege","volume":"20","author":"Schloffer H","year":"1907","journal-title":"Wien Klein Wochnschr"},{"key":"e_1_2_6_9_1","first-page":"1011","article-title":"Surgery of the pituitary gland, using the open trans\u2010sphenoidal approach. 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