Neurosurgical Approaches and Visual Outcomes in Pituitary Adenoma Surgery

Visual Outcomes in Pituitary Adenoma Surgery

Abstract

Objective: To evaluate the visual outcomes of patients undergoing pituitary adenoma surgery using transsphenoidal and transcranial approaches at Hayatabad Medical Complex, Peshawar. The study focused on identifying factors influencing visual recovery and comparing the effectiveness of both surgical methods. Study Design: retrospective study. Settings: Department of Neurosurgery, Hayatabad Medical Complex, Peshawar Pakistan. Duration: from January 2023 to December 2023. Methods: 100 patients divided into two groups: transsphenoidal (n = 50) and transcranial (n = 50). Patient demographics, tumour characteristics, and visual outcomes were analysed. Statistical analysis included chi-square tests, independent t-tests, and logistic regression, with a significance level of p<0.05. Results: The mean age of patients was 45.2 ± 13.4 years (transsphenoidal) and 47.6 ± 14.3 years (transcranial) (p = 0.421). Preoperative visual acuity was 20/200 ± 70 in the transsphenoidal group and 20/180 ± 65 in the transcranial group (p=0.325). Postoperatively, visual acuity improved to 20/50 ± 30 (transsphenoidal) and 20/100 ± 55 (transcranial) (p=0.005). Optic chiasm involvement was significantly higher in the transcranial group (80% vs. 10%, p<0.001). Logistic regression analysis identified the surgical approach as a significant predictor of visual improvement (OR: 2.13, 95% CI: 1.10-4.12, p = 0.028). Conclusion: Transsphenoidal surgery resulted in better visual outcomes than transcranial surgery. Tumour size and optic chiasm involvement significantly influenced recovery. Future research should focus on long-term outcomes and the development of patient selection criteria.