Surgical treatment of non-functioning pituitary macroadenomas by the endoscopic endonasal approach in the elderly Tratamento cirúrgico dos macroadenomas não secretores de hipófise por via endoscópica endonasal em idosos

Life expectancy has continued to increase in most developed countries over the past two centuries. It is estimated that three-quarters of all infants born since 2000 will live to an age of 75 years, whereas more than half of these infants will reach 100 years1. The life expectancy in Brazil has increased over the last century at a rate similar to that in most developed countries2. Aging populations lead to more elderly patients presenting neurosurgical problems; pituitary adenomas are a common finding in this age group, as has already been observed in a series of autopsies of elderly individuals3. Over the past three decades, several authors have published surgical series of elderly patients treated for pituitary adenomas, which account for 1.2% to 9% of all patients in the reported series4,5,6,7,8,9. This proportion increases to 14.6% if only non-functioning pituitary adenomas are considered10. Non-functioning pituitary adenomas are usually diagnosed as macroadenomas in elderly patients, at which point the adenomas become clinically relevant due to the local mass effect9,10,11. In these cases, because surgery provides decompression of the optic chiasm and may permit some degree of