Interdisciplinary Neurosurgery (Dec 2023)
Early post-operative diabetes insipidus following resection of craniopharyngioma: Incidence and predictors
Abstract
Objective: Craniopharyngiomas are tumors derived from the remains of epithelial cells that are attributed to incomplete closure of the pituitary or cricopharyngeal ducts. Although the tumor is considered benign, it has significant complications at diagnosis and following full resolution. The present study aimed to determine the prevalence and predictive factors of diabetes insipidus (DI) shortly after craniopharyngioma surgery. Methods: This study was retrospectively performed on 46 patients suffering from craniopharyngioma referred to Loghman Hakim Hospital sparing from 2011 to 2016. In patients with magnetic resonance imaging (MRI) and computerized tomography (CT) scans, endocrinology tests, other related tests, and complete neuromuscular examinations were performed before and after surgery. All patient information was collected descriptively according to their case, and quantitative data are displayed using mean, Standard Deviation, intermediate, and Interquartile range, and qualitative data are displayed using frequency and percentage. For analytical analysis, the data were calculated from independent samples t, Mann-Whitney statistical tests, K2 test, and, if necessary, Fisher's precise P-Value. A significant level was considered for the 5 % statistical tests, and the SPSS statistical software version 25 was used to analyze the data. Results: Most patients were male (58 %), and the mean age of patients was 33 years, the youngest being 5 years and the oldest being 71 years. Patients' symptoms at the time of referral include visual impairment (58 %), headache (56 %), balance disorder 19 %, nausea and vomiting 13 %, and memory impairment (8 %). The prevalence of DI was reported to be 50 % after surgery, significantly associated with tumor size. No other significant association was found between the plurality of DI after surgery and other variables studied. Conclusions: The present study showed no predictive factor for post-operative DI in patients with craniopharyngioma. It can only be concluded that patients with larger tumor sizes are more likely to develop DI; however, more studies are warranted to achieve a definitive conclusion.
