[Neurosurgical treatment of acromegaly]

The results of transsphenoidal surgery in 45 consecutive patients with pituitary adenoma and acromegaly are reviewed. The cure rate defined in clinical terms is specifically related to the size of the adenoma. 20 out of 21 patients with intrasellar adenomas were cured by surgery. Of 24 patients with extrasellar adenomas eight were cured and ten had improved, while six had no clinical effect of the operation. Overall 62.2% were cured, 24.4% had improved and 13.3% were unchanged. The complications were 3 patients with pituitary insufficiency, rhinoliquorrhoea successfully treated with surgery in one patient, and an internal carotid artery lesion treated with trapping without sequelae in one patient. No recurrences were observed over two years. It is concluded that treatment of acromegaly is teamwork for internists and surgeons, and that transsphenoidal pituitary surgery is at present the primary treatment of choice.