Diabetes Insipidus After Endoscopic Transsphenoidal Surgery

Area of Science:

• Neurosurgery
• Endocrinology
• Oncology

Background:

• Diabetes insipidus (DI) is a known complication of transsphenoidal surgery (TSS) for pituitary tumors.
• Understanding the incidence and predictors of DI post-TSS is crucial for patient management.

Purpose of the Study:

• To report on the incidence of DI following TSS for pituitary adenoma, Rathke cleft cyst, and craniopharyngioma.
• To identify patient and tumor characteristics that predict the development of transient or permanent DI.

Main Methods:

• Retrospective analysis of 700 patients undergoing endoscopic TSS.
• Inclusion criteria: at least 1-week follow-up for DI diagnosis.
• Multivariable logistic regression used to identify predictors of DI.

Main Results:

• Overall postoperative DI rate was 14.7%; permanent DI occurred in 4.6% of patients with at least 1-year follow-up.
• Patients with Rathke cleft cysts (RCC) and craniopharyngiomas had significantly higher odds of developing DI compared to pituitary adenomas (PA).
• RCC and craniopharyngioma were also strong predictors of permanent DI.

Conclusions:

• Transient DI is a common complication of TSS, but permanent DI is infrequent.
• The specific pathology (tumor type) is a significant predictor for both the occurrence and permanence of postoperative DI.