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September 22, 1975

AcromegalyTreatment by Transsphenoidal Microsurgery

Author Affiliations

From the Department of Endocrinology and Metabolism, Walter Reed Army Institute of Research (Drs. Atkinson, Schaaf, Dimond, Wartofsky, and Earll), the Department of Neurosurgery, Walter Reed Army Medical Center (Dr. Martin), Washington, DC, and the Division of Neurosurgery, Medical College of Virginia, Virginia Commonwealth University, Richmond (Dr. Becker).

JAMA. 1975;233(12):1279-1283. doi:10.1001/jama.1975.03260120041018

Serum growth hormone levels, thyroid function, and adrenal function were measured before and after surgery in 16 of 17 acromegalic patients undergoing transnasal transsphenoidal microsurgery of the pituitary. Thirteen patients have been followed up for 12 to 24 months; three patients have been followed up for three to six months. Serum growth hormone levels decreased to less than 5 ng/ml in seven of nine previously untreated patients; thyroid and adrenal function were preserved in eight of these nine patients. In seven patients treated previously by other modes of therapy, growth hormone levels after transsphenoidal surgery decreased to less than 5 ng/ml in three, to between 5 and 10 ng/ml in three, and from 98 to 41 ng/ml in one. Preoperative adrenal function was normal in six of these seven patients and was preserved in four; thyroid function was normal in five patients preoperatively and was preserved in three.

Transsphenoidal microsurgery appears to offer an effective means of lowering growth hormone levels and a possibility of preserving any remaining normal pituitary function. It may be considered for initial treatment in selected patients in whom more rapid arrest of acromegaly is indicated.

(JAMA 233:1279-1283, 1975)