Maydannyk O. Surgical treatment of giant pituitary adenomas

Dissertation deals with the problem of improvement of surgical treatment for giant pituitary adenomas. We consider the differences of disease, neurological symptoms, endocrine manifestations, instrumental and laboratory diagnostic of giant pituitary adenomas, especially their spatial distribution, compared with a group of pituitary adenomas in general. Developed and used in practice modified scheme of choice of surgical approach to GPA, whichbased on the spatial and radiological characteristics of this tumors according to preoperative MRI. It is making possible to individualize and identify principles of differential choice of a surgical approach, and their combination over time in patients with GPA, which subsequently positively reflected on the results of the treatment. Developed and implemented in practice integrated scale of clinical evaluation of patients with GPA. Allowing scale patients were divided into groups according to the severity of the disease before the surgery in order to facilitate determination of the degree of surgical risk and, subsequently, optimized clinical evaluation of functional results of the treatment in postoperative period. Based on analysis of early and late results proved that the use of a wide range of surgical approaches as transsphenoidal and transcranial and their combinations, together with the use of neuronavigation, surgical microscope and endoscopic assistance, provides a clinical improvement in most operated patients. The results of this research work have found application in neurosurgical practice.