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Kalinin P.L.
NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva
Shkarubo A.N.
FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva
Astaf'eva L.I.
NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva
Chernov I.V.
Sechenov First Moscow State Medical University, Moscow, Russia
Ismailov D.B.
Burdenko Neurosurgical Institute, Moscow, Russia
Kadashev B.A.
NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva
Fomichev D.V.
Burdenko Neurosurgical Institute, Moscow, Russia
Kutin M.A.
NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva
Sharipov O.I.
Burdenko Neurosurgical Institute, Moscow, Russian Federation
Andreev D.N.
GBOU VPO "Moskovskiĭ gosudarstvennyĭ mediko-stomatologicheskiĭ universitet im. A.I. Evdokimova" Minzdrava Rossii
Fomochkina L.A.
FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva
Cerebrospinal fluid rhinorrhea in primary treatment of large and giant prolactinomas with dopamine agonists
Journal: Burdenko's Journal of Neurosurgery. 2017;81(6): 32‑39
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To cite this article:
Kalinin PL, Shkarubo AN, Astaf'eva LI, et al. . Cerebrospinal fluid rhinorrhea in primary treatment of large and giant prolactinomas with dopamine agonists. Burdenko's Journal of Neurosurgery.
2017;81(6):32‑39. (In Russ., In Engl.)
https://doi.org/10.17116/neiro201781632-39
At present, pharmacological therapy of prolactinomas with dopamine agonists (DAs) is considered the treatment of choice. In most cases, giant prolactinomas respond to treatment with dopamine agonists and decrease in size during the first months of the treatment. One of the rare but dangerous complications of conservative treatment of prolactinomas with invasive growth is cerebrospinal fluid rhinorrhea. Material and methods. We present a retrospective analysis of 15 patients with macropropactinomas who underwent surgery for cerebrospinal fluid rhinorrhea developed due to primary therapy with dopamine agonists at the Burdenko Neurosurgical Institute (BNI) in the period between 2005 and 2015. All patients had large and giant tumors (according to the classification adopted at the BNI). When cerebrospinal fluid rhinorrhea was detected, patients were hospitalized to the BNI for examination, detection of a CSF fistula, reconstruction of a defect, and resection (if possible) of the tumor. Results. In the period between 2005 and 2015, 15 patients (8 males and 7 females) with prolactinomas of a large and giant size at the onset of conservative therapy underwent surgery for cerebrospinal fluid rhinorrhea at the BNI. All patients underwent transnasal reconstruction of a skull base defect, with 13 out of 15 patients undergoing simultaneous resection of the tumor. After tumor resection, reconstruction was performed using auto-fat, fascia, and glue (in 8 cases). In the remaining cases, apart from auto-fat, fascia, and glue, a mucoperiosteal flap and auto-bone were used. Fourteen patients were followe-up. In 13 cases, there was no relapse of cerebrospinal fluid rhinorrhea after skull base reconstruction. In 1 case, there was a relapse of cerebrospinal fluid rhinorrhea. Conclusion. Conservative treatment of patients with giant prolactinomas should be performed under regular control of ENT doctors and neurosurgeons for timely detection and surgical treatment of cerebrospinal fluid rhinorrhea.
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Authors:
Kalinin P.L.
NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva
Shkarubo A.N.
FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva
Astaf'eva L.I.
NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva
Chernov I.V.
Sechenov First Moscow State Medical University, Moscow, Russia
Ismailov D.B.
Burdenko Neurosurgical Institute, Moscow, Russia
Kadashev B.A.
NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva
Fomichev D.V.
Burdenko Neurosurgical Institute, Moscow, Russia
Kutin M.A.
NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva
Sharipov O.I.
Burdenko Neurosurgical Institute, Moscow, Russian Federation
Andreev D.N.
GBOU VPO "Moskovskiĭ gosudarstvennyĭ mediko-stomatologicheskiĭ universitet im. A.I. Evdokimova" Minzdrava Rossii
Fomochkina L.A.
FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva
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