{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T15:59:00Z","timestamp":1773158340504,"version":"3.50.1"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Nonfunctioning pituitary adenomas (NFPA) are common, benign lesions of the pituitary gland. The endoscopic endonasal approach (EEA) has improved their treatment. Large multi-center data across different healthcare systems on outcomes following EEA resection of NFPA are limited. We aimed to provide highly generalizable benchmark outcomes from an international, multi-center review of EEA for NFPA resection.<\/jats:p>\n                  <jats:p>Institution-level data on symptoms, tumor and intraoperative characteristics, complications, and long-term outcomes were obtained from four tertiary pituitary centers located in the United States (2), Italy (1), and Austria (1). Means and weighted averages were used to generate descriptive statistics of patient characteristics and outcomes.<\/jats:p>\n                  <jats:p>A total of 1,097 patients who underwent EEA for NFPA were included (mean age: 55.3 years). Presenting symptoms included vision loss (55.2%) and headache (42.1%). The most common preoperative endocrinopathies were hyperprolactinemia (26%) and hypothyroidism (18%). The gross total resection rate was 66%. Patients presenting with headache and visual symptoms experienced improvement (81 and 89%, respectively). Common complications included delayed hyponatremia (7.5%), transient arginine vasopressin deficiency (AVP-D; 6.6%), cerebrospinal fluid leak (3.5%), new endocrinopathy (3.5%), and new cranial nerve palsy (0.8%). There were no instances of carotid artery injury. Stroke (0.4%) and death (0.1%) were exceedingly rare. During the mean follow-up of 30 months, &lt;5% of patients underwent reoperation or radiation-based treatments.<\/jats:p>\n                  <jats:p>In this large, international series, EEA proved a safe and effective intervention that was generalizable across centers in the United States and Europe. Severe complications were rare, and significant improvements in headache and vision loss were noted in most patients.<\/jats:p>","DOI":"10.1055\/a-2538-3928","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T19:21:51Z","timestamp":1741029711000},"page":"151-156","source":"Crossref","is-referenced-by-count":0,"title":["Multi-Center, Multi-National Outcomes Following Endoscopic Endonasal Resection of Nonfunctional Pituitary Adenomas"],"prefix":"10.1055","volume":"87","author":[{"given":"Robert G.","family":"Briggs","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhiraj J.","family":"Pangal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7561-4590","authenticated-orcid":false,"given":"Shane","family":"Shahrestani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Cote","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie K.","family":"Cheok","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Ruzevick","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington School of Medicine, Seattle, Washington, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben A.","family":"Strickland","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin J.","family":"Rutkowski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaria","family":"Bove","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey J.","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0910-5956","authenticated-orcid":false,"given":"Ishan","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Gomez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle M.","family":"Hurth","sequence":"additional","affiliation":[{"name":"Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Shiroishi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bozena","family":"Wrobel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John D.","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Micko","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Graz, Styria, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Wolfsberger","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Graz, Styria, Austria"},{"name":"Department of Neurosurgery, Medical University of Vienna, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Engelbert","family":"Knosp","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Graz, Styria, Austria"},{"name":"Department of Neurosurgery, Medical University of Vienna, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, School of Medicine and Surgery, Universit\u00e1 degli Studi di Napoli Federico II, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Cappabianca","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, School of Medicine and Surgery, Universit\u00e1 degli Studi di Napoli Federico II, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward R.","family":"Laws","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Zada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los 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Karsy","year":"2022","journal-title":"J Neurol Surg B Skull Base"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1093\/ejendo\/lvad124","article-title":"Defining benchmark outcomes for transsphenoidal surgery of pituitary adenomas: a multicenter analysis","volume":"189","author":"R Drexler","year":"2023","journal-title":"Eur J Endocrinol"},{"issue":"10","key":"ref11","doi-asserted-by":"crossref","first-page":"4709","DOI":"10.1210\/jc.2003-030461","article-title":"Transsphenoidal surgery for pituitary tumors in the United States, 1996-2000: mortality, morbidity, and the effects of hospital and surgeon volume","volume":"88","author":"F G Barker II","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1227\/NEU.0b013e31826d5d06","article-title":"Pituitary centers of excellence","volume":"71","author":"N 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