The degree of invasion of the pituitary adenoma into the cavernous sinus as one of the factors affecting the quality of life and intellectual-mnestic function before and after resection

Introduction. Invasion of pituitary adenoma into the cavity of the cavernous sinus occurs in 10-15% of cases. Due to the high frequency of invasion into the cavernous sinus, the question of changes in the quality of life, intellect, memory in such patients is relevant.

Material and methods. The study included 45 patients with pituitary adenoma aged 22 to 63 years (median 45 years). The quality of life questionnaire EORTC QLQ-C30; intellect tests – Amthauer, Raven tests; memory tests – 10-word test, Wexler scale were used to assess the parameters.

Results. To determine the degree of invasion of pituitary adenoma into the cavity of the cavernous sinus, MRI sections at the level of the Turkish saddle and Knosp Scale were used. The patients included in the study had the following Knosp Scale grades: Grade 0 in 13,3%, Grade I – 71,1%, Grade II – 8,9%, Grade III – 6,7%. It was revealed that in patients with Grade III, visual disorders were more often preserved in the postoperative period (p<0,5). Also we found that sleep disorders before surgery were most frequently observed in Grade III patients, and in the late postoperative period this group of patients had lower values of physical, role, cognitive, emotional functioning, increased fatigue, severe pain, financial difficulties and a lower self-assessment of health status (p<0,05). Besides, at all stages of treatment there was a decrease in mnestic abilities (Amthauer test); in the late postoperative period – more frequent mnestic disorders, mild-degree decrease in a long-term memory (p<0,5).

Conclusion. Invasion of pituitary adenoma in the cavernous sinus of Grade III by the Knosp Scale adversely affects the quality of life and intellectual-mnestic function at all stages of treatment.

Key words: pituitary adenoma, cavernous sinus, intellectual-mnestic function.

Conflicts of interest. The authors have no conflicts of interest to declare.

Funding. There was no funding for this study.

For citation: Cherebillo V.Y., Kurnukhina M.Y., Gusev A.A., Puzakov N.S. The degree of invasion of the pituitary adenoma into the cavernous sinus as one of the factors affecting the quality of life and intellectual-mnestic function before and after resection. Golova i sheya. Rossijskij zhurnal Head and neck Russian Journal. 2020;8(2):16–21 (in Russian).

The authors are responsible for the originality of the data presented and the possibility of publishing illustrative material – tables, figures, photographs of patients.