Alzhrani G, et al. - In this work, researchers aimed at describing delayed complications after transsphenoidal surgery and discuss the incidence, temporality from the surgery, and management of these complications. Findings revealed a low incidence of some of the complications. However, they recognized providing preoperative counseling to patients with pituitary tumors regarding the delayed complications and proper postoperative follow-up planning as an important part of treatment planning.

Methods

• The findings of studies that reported delayed postoperative epistaxis, delayed postoperative cavernous carotid pseudoaneurysm formation and rupture, vasospasm, delayed symptomatic hyponatremia (DSH), hypopituitarism, hydrocephalus, and sinonasal complications were used.

• This review suggested an incidence of 0.6–3.3% for delayed postoperative epistaxis at 1–3 weeks postoperatively.
• There were reports of 18 cases with delayed carotid artery pseudoaneurysm formation at 2 days to 10 years postoperatively.
• 30 reported cases for postoperative vasospasm occurring 8 days postoperatively were identified.
• At 4–7 days, 3.6–19.8% rate of DSH was observed postoperatively.
• 3.1% rate of new-onset hypopituitarism at 2 months was notied postoperatively.
• A 0.4–5.8% rate of hydrocephalus within 2.2 months postoperatively was observed.
• After transsphenoidal surgery, sinonasal complications were commonly reported; however, spontaneous resolutions within 3–12 months had been reported.