{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:31:36Z","timestamp":1761823896017},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Pituitary adenomas are uncommon in childhood. Although medical treatment can be effective in treating prolactinomas and some growth hormone (GH)\u2013secreting tumors, resection is indicated when visual function is affected or the side effects of medical therapy are intolerable. The authors of this report describe their 10-year experience in managing pituitary adenomas via the microscopic endonasal transsphenoidal approach in a pediatric population.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>They performed a retrospective review of a surgical case series based at a single institution and consisting of 34 consecutive pediatric patients with endocrine-active (32 patients) and endocrine-inactive (2 patients) adenomas. These patients were surgically treated via an endonasal transsphenoidal approach between 1999 and 2008. Patient charts were reviewed, and clinical data were compiled and analyzed using the chi-square and Kaplan-Meier tests.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The patient cohort consisted of 20 girls and 14 boys, with ages ranging from 9 to 18 years and a median age of 16 years. Thirty-two patients (94%) underwent surgery for endocrine-active tumors, including 10 (29%) with Cushing disease, 21 (62%) with prolactinomas, and 1 (3%) with GH-secreting tumors. Two patients with nonsecreting adenomas underwent surgery for apoplexy. The mean tumor volume was 5.4 cm<jats:sup>3<\/jats:sup>, and 13 patients (38%) had suprasellar extension and 7 (21%) had cavernous sinus invasion. Gross-total resection was achieved in 26 patients (76%), although it was significantly less likely to be achieved in the setting of cavernous sinus invasion (p &lt; 0.001) but was unaffected by suprasellar extension. Residual tumor was treated with radiation therapy in 6 patients (18%). The average duration of hospital stay was 1.6 days. The median follow-up time was 18 months. After surgery, 19 patients (56%) had normal hormone function without adjuvant therapy, 8 (24%) had normal function with adjuvant therapy, and 5 (15%) had persistently elevated hormone levels. Patients with a macroprolactinoma were significantly more likely to require postoperative adjuvant therapy than were those with a microprolactinoma (p &lt; 0.03).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Endonasal transsphenoidal resection is a safe, well-tolerated, and potentially curative treatment option for pituitary adenomas in children. Despite the technical challenges associated with this approach in the pediatric population, these tumors can be effectively managed with minimal morbidity. Endocrine function is usually preserved, and the majority of patients will not require lifelong medical therapy.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.2.peds10278","type":"journal-article","created":{"date-parts":[[2016,12,27]],"date-time":"2016-12-27T13:07:55Z","timestamp":1482844075000},"page":"501-509","source":"Crossref","is-referenced-by-count":27,"title":["Microscopic endonasal transsphenoidal pituitary adenomectomy in the pediatric population"],"prefix":"10.3171","volume":"7","author":[{"given":"Phiroz E.","family":"Tarapore","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael E.","family":"Sughrue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lewis","family":"Blevins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kurtis I.","family":"Auguste","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nalin","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep","family":"Kunwar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0070501","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"3411","DOI":"10.1210\/jcem.83.10.5111","article-title":"Transsphenoidal microsurgery for growth hormone-secreting pituitary adenomas: initial outcome and long-term results","volume":"83","author":"Abosch","year":"1998"},{"key":"b2-0070501","series-title":"Neurol Res","first-page":"415","article-title":"Pituitary tumors in adolescent patients","volume":"20","author":"Artese","year":"1998"},{"key":"b3-0070501","series-title":"Clin Endocrinol (Oxf)","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1111\/j.1365-2265.2005.02293.x","article-title":"Long-term remission following withdrawal of dopamine agonist therapy in subjects with microprolactinomas","volume":"63","author":"Biswas","year":"2005"},{"key":"b4-0070501","series-title":"Clin Endocrinol (Oxf)","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1046\/j.1365-2265.2003.01748.x","article-title":"Clinical presentation and outcome of pituitary adenomas in teenagers","volume":"58","author":"Cannav\u00f2","year":"2003"},{"key":"b5-0070501","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1007\/s11102-008-0087-5","article-title":"Endoscopic pituitary surgery","volume":"11","author":"Cappabianca","year":"2008"},{"key":"b6-0070501","series-title":"Otolaryngol Clin North Am","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1016\/S0030-6665(05)70371-6","article-title":"Pituitary surgery","volume":"34","author":"Carrau","year":"2001"},{"key":"b7-0070501","series-title":"Otolaryngol Clin North Am","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1016\/j.otc.2009.02.001","article-title":"The diagnosis and management of empty nose syndrome","volume":"42","author":"Chhabra","year":"2009"},{"key":"b8-0070501","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1097\/00006123-199702000-00001","article-title":"Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience","volume":"40","author":"Ciric","year":"1997"},{"key":"b9-0070501","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1056\/NEJMoa022657","article-title":"Withdrawal of long-term cabergoline therapy for tumoral and nontumoral hyperprolactinemia","volume":"349","author":"Colao","year":"2003"},{"key":"b10-0070501","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1016\/j.surneu.2009.04.012","article-title":"Fully endoscopic transsphenoidal surgery for functioning pituitary adenomas: a retrospective comparison with traditional transsphenoidal microsurgery in the same institution","volume":"72","author":"D'Haens","year":"2009"},{"key":"b11-0070501","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1007\/s003810000350","article-title":"The role of the endoscopic transsphenoidal approach in pediatric neurosurgery","volume":"16","author":"de Divitiis","year":"2000"},{"key":"b12-0070501","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1007\/s00701-009-0487-y","article-title":"Endonasal endoscopic pituitary surgery: is it a matter of fashion?","volume":"152","author":"Fernandez-Miranda","year":"2010"},{"key":"b13-0070501","series-title":"J Pediatr Endocrinol Metab","first-page":"261","article-title":"Peripubertal prolactinomas: clinical presentation and long-term outcome with different therapeutic approaches","volume":"13","author":"Fideleff","year":"2000"},{"key":"b14-0070501","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1469","DOI":"10.1007\/s00381-008-0710-9","article-title":"Combined endoscopic and microscopic management of pediatric pituitary region tumors through one nostril: technical note with case illustrations","volume":"24","author":"Frazier","year":"2008"},{"key":"b15-0070501","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"140","DOI":"10.3171\/jns.1987.66.1.0140","article-title":"A direct transnasal approach to the sphenoid sinus. Technical note","volume":"66","author":"Griffith","year":"1987"},{"key":"b16-0070501","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1227\/00006123-199110000-00004","article-title":"Pediatric pituitary tumors","volume":"29","author":"Haddad","year":"1991"},{"key":"b17-0070501","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1001\/jama.1910.04330090046014","article-title":"Endonasal method of removal of hypophyseal tumors. With a report of two successful cases","volume":"55","author":"Hirsch","year":"1910"},{"key":"b18-0070501","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1016\/j.otohns.2005.04.017","article-title":"Empty nose syndrome associated with middle turbinate resection","volume":"135","author":"Houser","year":"2006"},{"key":"b19-0070501","series-title":"J Clin Endocrinol Metab","first-page":"1135","article-title":"Pituitary adenomas in childhood and adolescence","volume":"79","author":"Kane","year":"1994"},{"key":"b20-0070501","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"4385","DOI":"10.1210\/jcem.84.12.6240","article-title":"Pediatric pituitary adenomas","volume":"84","author":"Kunwar","year":"1999"},{"key":"b21-0070501","series-title":"Prog Exp Tumor Res","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1159\/000413694","article-title":"Pituitary adenomas in childhood and adolescence","volume":"30","author":"Laws","year":"1987"},{"key":"b22-0070501","series-title":"Prog Exp Tumor Res","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1159\/000413695","article-title":"Special problems with neurosurgical treatments of hormone-secreting pituitary adenomas in children","volume":"30","author":"L\u00fcdecke","year":"1987"},{"key":"b23-0070501","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1227\/00006123-199502000-00004","article-title":"Pediatric pituitary adenomas","volume":"36","author":"Mindermann","year":"1995"},{"key":"b24-0070501","series-title":"J Pediatr Endocrinol Metab","first-page":"79","article-title":"Pituitary adenomas in childhood and adolescence","volume":"8","author":"Mindermann","year":"1995"},{"key":"b25-0070501","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3171\/jns.1994.80.2.0209","article-title":"Pituitary adenomas in childhood and adolescence. Results of transsphenoidal surgery","volume":"80","author":"Partington","year":"1994"},{"key":"b26-0070501","series-title":"Wien Klin Wochenschr","first-page":"621","article-title":"Erfolgreiche Operationen eines Hypophysentumors auf Nasalem Wege","volume":"20","author":"Schloffer","year":"1907"},{"key":"b27-0070501","series-title":"Bruns Beitr Klin Chir","first-page":"767","article-title":"Zur Frage der Operationen an der Hypophyse","volume":"50","author":"Schloffer","year":"1906"},{"key":"b28-0070501","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1055\/s-0029-1246161","article-title":"Surgical repair of persisting CSF leaks following standard or extended endoscopic transsphenoidal surgery for pituitary tumor","volume":"53","author":"Sciarretta","year":"2010"},{"key":"b29-0070501","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1007\/s11102-008-0135-1","article-title":"Pre-operative dopamine agonist therapy improves post-operative tumor control following prolactinoma resection","volume":"12","author":"Sughrue","year":"2009"},{"key":"b30-0070501","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1227\/01.NEU.0000374722.50042.FF","article-title":"Utility of the immediate postoperative cortisol concentrations in patients with Cushing's disease","volume":"67","author":"Sughrue","year":"2010"},{"key":"b31-0070501","series-title":"Arch Pathol Lab Med","doi-asserted-by":"publisher","first-page":"77","DOI":"10.5858\/2008-132-77-PPA","article-title":"Pediatric pituitary adenomas","volume":"132","author":"Webb","year":"2008"},{"key":"b32-0070501","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"350","DOI":"10.3171\/jns.2003.98.2.0350","article-title":"Endonasal transsphenoidal approach for pituitary adenomas and other sellar lesions: an assessment of efficacy, safety, and patient impressions","volume":"98","author":"Zada","year":"2003"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/7\/5\/article-p501.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/7\/5\/article-p501.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/7\/5\/article-p501.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T15:36:22Z","timestamp":1681572982000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/7\/5\/article-p501.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2011,5]]},"references-count":32,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2011.2.peds10278","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,5]]}}}