Correlation of Pituitary Descent and Diabetes Insipidus Following Transsphenoidal Pituitary Adenoma Resection

Introduction: Pituitary adenomas (PAs) are a common type of neoplasm arising from the pituitary gland. Endoscopic transsphenoidal surgery remains the technique of choice for resection of these tumors; however, major complications include cerebrospinal fluid leak, infections, hypopituitarism, carotid artery injury, and central diabetes insipidus (DI) among others. Postoperative DI is most often transient and observed in 1.6 to 34% of patients, while permanent DI has been reported in 0 to 2.7% of patients. Incidence of postoperative DI has been correlated with an intraoperative cerebrospinal fluid leak, Cushing's disease, decreased tumor size, and changes in serum sodium. The proposed mechanism was the transduction of traction forces exerted by the surgeon on the descended diaphragma sellae and through the pituitary stalk.