Long-Term Surgical Outcomes in Patients with Cushing's Disease: A Single-Center Study

Objective: This study was performed to analyze the results of patients who underwent the endoscopic endonasal surgery (EES) for Cushing’s disease (CD) in our department and to determine the surgical outcomes, recurrence and complication rates. Materials and Methods: We retrospectively reviewed data from 28 patients with CD who underwent endoscopic endonasal surgery in our department between 2013 and 2024. Data collection included radiological findings, preoperative hormonal profiles, operative details, postoperative follow-up data. The radiological evaluation comprised a detailed examination of preoperative magnetic resonance images (MRIs), including inferior petrosal sinus sampling (IPSS). True remission was defined as a morning serum cortisol < 138 nmol/L within first 7 days of surgery, normal 24-hour urinary free cortisol, or continued need for hydrocortisone replacement after surgery. A strict cut-off of < 50 nmol/L at day 3 post-op was also applied, to allow early identification of remission. Results: A total of 28 patients underwent endoscopic endonasal surgery. Preoperative MRI localised an adenoma in 24 (85.7%) patients; 20 microadenoma and 4 macroadenoma. Seven patients had tumors with cavernous sinus invasion. IPSS was performed in 20 (71.4%) patients. The rate of biochemical remission was 82.1% (23/28). There were 5 cases of recurrence of CD during the follow-up period. Transient diabetes insipidus occurred in 7 (25%) patients. Conclusion: EES is a safe and effective treatment method for Cushing’s disease with satisfactory remission rates. It provides access to the cavernous sinus. Selective resection of the medial wall of the cavernous sinus in case of invading of tumor, is critical for increasing remission rate. Publication History Article published online: 27 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany