{"id":16330,"date":"2025-03-04T11:03:44","date_gmt":"2025-03-04T10:03:44","guid":{"rendered":"https:\/\/www.neurochirurgie-lariboisiere.com\/?p=16330"},"modified":"2025-03-04T11:08:06","modified_gmt":"2025-03-04T10:08:06","slug":"efficacy-of-endoscopic-endonasal-transsphenoidal-surgery-for-cushings-disease-in-230-patients-with-positive-and-negative-mri","status":"publish","type":"post","link":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/2025\/03\/04\/efficacy-of-endoscopic-endonasal-transsphenoidal-surgery-for-cushings-disease-in-230-patients-with-positive-and-negative-mri\/","title":{"rendered":"Efficacy of Endoscopic Endonasal Transsphenoidal Surgery for Cushing\u2019s Disease in 230 Patients with Positive and Negative MRI"},"content":{"rendered":"\n

<\/p>\n\n\n\n

Introduction<\/strong><\/p>\n\n\n\n

Cushing\u2019s disease is a rare endocrine disorder caused by an excess production of cortisol due to a pituitary adenoma. Endoscopic endonasal transsphenoidal surgery (EETS) is the gold standard for tumor removal, but its effectiveness varies depending on MRI findings. This study evaluates the remission rate, complications, recurrence risk, and predictive factors for surgical success.
<\/p>\n\n\n\n

Study Design and Methodology<\/strong><\/p>\n\n\n\n

This prospective single-center study analyzed 230 consecutive adult patients<\/strong> (over 18 years old) who underwent EETS for Cushing\u2019s disease between 2008 and 2013<\/strong> by a single neurosurgeon. All patients had confirmed clinical and biological signs of Cushing\u2019s disease, with or without pituitary tumor detection on dedicated MRI.<\/p>\n\n\n\n

\ud83d\udd39 Remission Criteria<\/strong>: Biochemical remission was defined as a postoperative serum cortisol level <5 \u03bcg\/dl<\/strong> on the second day after surgery, requiring glucocorticoid replacement therapy.
<\/p>\n\n\n\n

Key Findings<\/strong><\/p>\n\n\n\n

\ud83d\udccc Overall remission rate<\/strong>: 79.1%<\/strong> (182\/230 patients).<\/p>\n\n\n\n

\ud83d\udccc Patients with positive MRI<\/strong>: 82.5% remission rate<\/strong> (132\/160).<\/p>\n\n\n\n

\ud83d\udccc Patients with negative MRI<\/strong>: 71.4% remission rate<\/strong> (50\/70).<\/p>\n\n\n\n

\ud83d\udccc No significant statistical difference<\/strong> between the two groups (p = 0.077).
<\/p>\n\n\n\n

Complications and Recurrence<\/strong><\/p>\n\n\n\n

\ud83d\udca1 Postoperative complications<\/strong> occurred in 77 patients<\/strong>, but no deaths were reported.<\/p>\n\n\n\n

\ud83d\udca1 Diabetes insipidus<\/strong> was observed in 22% (transient)<\/strong> and 6.4% (long-term)<\/strong> of cases.<\/p>\n\n\n\n

\ud83d\udca1 No cerebrospinal fluid (CSF) leakage<\/strong> was recorded postoperatively.<\/p>\n\n\n\n

\ud83d\udca1 Recurrence rate<\/strong>: 9.8%<\/strong>, with a mean recurrence time of 32.7 \u00b1 15.2 months<\/strong>.
<\/p>\n\n\n\n

Predictive Factors for Remission<\/strong><\/p>\n\n\n\n

\ud83d\udd39 The presence of pituitary microadenoma<\/strong> on MRI was associated with higher remission rates.<\/p>\n\n\n\n

\ud83d\udd39 A positive MRI<\/strong> (showing a visible adenoma) was a favorable factor for surgical success.
<\/p>\n\n\n\n

Conclusion<\/strong><\/p>\n\n\n\n

Endoscopic endonasal transsphenoidal surgery is an effective and safe<\/strong> treatment option for Cushing\u2019s disease, achieving high remission rates even in patients with negative MRI findings. Early detection of microadenomas and careful patient selection can improve surgical outcomes.<\/p>\n","protected":false},"excerpt":{"rendered":"

Introduction Cushing\u2019s disease is a rare endocrine disorder caused by an excess production of cortisol due to a pituitary adenoma. Endoscopic endonasal transsphenoidal surgery (EETS) is the gold standard for tumor removal, but its effectiveness varies depending on MRI findings….<\/p>\n","protected":false},"author":24,"featured_media":15553,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-16330","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/posts\/16330","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/users\/24"}],"replies":[{"embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/comments?post=16330"}],"version-history":[{"count":1,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/posts\/16330\/revisions"}],"predecessor-version":[{"id":16333,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/posts\/16330\/revisions\/16333"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/media\/15553"}],"wp:attachment":[{"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/media?parent=16330"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/categories?post=16330"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/tags?post=16330"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}