Results of microsurgery in Cushing's disease and effect on hypertension

In 100 consecutive transnasal sellar explorations in suspected Cushing's disease, 88 pituitary adenomas were removed. The initial remission rate in adenoma cases was about 90%. Complications related to surgery had been rare. Regularly after complete selective adenomectomy a period of ACTH and cortisol deficiency was found (90%). In these patients only 1 recurrence was seen whereas from 5 patients without cortisol deficit a relapse occurred in 4. Hypertension was found in 80% of patients with verified Cushing's disease. With normalization of cortisol excess, hypertension disappeared in 75% and was ameliorated in 15%.