Clinical characteristics and risk factors of delayed ophthalmoplegia following cavernous sinus exploration in endoscopic pituitary adenoma surgery : Delayed transient ophthalmoplegia
Authors' conclusion
Postoperative ophthalmoplegia following cavernous sinus exploration occurs more frequently than previously reported but follows a benign course with near-complete resolution. The distinct temporal patterns and risk factors suggest different pathophysiological mechanisms for early- versus delayed-onset ophthalmoplegia, guiding surgical decisions and patient counseling.
Study context
- Population
- Patients undergoing endoscopic skull base surgery with cavernous sinus exploration for pituitary neuroendocrine tumors (PitNETs) (pituitary adenomas), March 2020–September 2024consecutive
- Participants
- 127 patients
- Outcome
- Clinical features, risk factors and recovery patterns of postoperative ophthalmoplegia following cavernous sinus exploration
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
New cranial nerve dysfunction (exclusively ophthalmoplegia)
- New cranial nerve dysfunction, manifesting exclusively as ophthalmoplegia
- 13.6% (17/125)
- Abducens nerve affected
- 52.9%
- Oculomotor nerve affected
- 41.2%
- Trochlear nerve affected
- 11.8%
- Early onset (≤ 3 days)
- 29.4%
- Delayed onset (> 3 days)
- 70.6%
- Mean onset
- 9 days
- Risk factor: extensive hemostatic agent use (≥ 3 applications), OR
- 15.57, p < 0.001
- Risk factor: lateral compartment involvement, OR
- 9.00, p = 0.011
- Complete resolution
- 94.1%
- Median duration
- 20 days
Observational data: associations, not effects.
Further findings
Gross total resection
- Overall gross total resection rate
- 74.8%
- Gross total resection, functioning adenomas
- 96.9%
Biochemical remission in functioning PitNETs · 3-month follow-up
- Biochemical remission
- 96.9%
Original publication
Clinical characteristics and risk factors of delayed ophthalmoplegia following cavernous sinus exploration in endoscopic pituitary adenoma surgery : Delayed transient ophthalmoplegia. Pituitary. Published 19 January 2026. doi:10.
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