Background: Diabetes insipidus is a common complication following sellar or parasellar surgery
involving the pituitary gland. Although this is fairly transient and typically has
an onset within 24 to 48 hours of surgery, it is unclear if the postoperative timing
of the need for desmopressin administration is predictive of long-term replacement.
Methods: We reviewed 81 consecutive patients undergoing endoscopic endonasal surgery for sellar/parasellar
pathology involving the pituitary gland or infundibulum. Data evaluated included age,
gender, pathology, sellar versus suprasellar origin of pathology, tumor size, Knosp
grade, preoperative visual status, intraoperative CSF leak, timing of desmopressin
dosing, other postoperative endocrinopathies.
Results: Thirty patients (37%) required at least one dose of desmopressin at some point during
their postoperative course. Only 13 patients (16%) required desmopressin on hospital
discharge, and 12 of the 13 remained on replacement at last follow-up while 1 additional
patient required long-term desmopressin initiation after discharge. The most predictive
variable for long-term desmopressin need was initial dosing within 12 hours of completion
of the surgical procedure (p < 0.05)
Conclusion: Postoperative diabetes insipidus following EEA resection of sellar and parasellar
tumors can be common and a potentially serious complication. The need for desmopressin
administration within 12 hours postoperatively is high predictive of the need for
long-term treatment.
