Abstract
Pituitary adenomas are the most common sellar pathology. They can be classified according to size (micro vs. macroadenomas) and according to endocrine function (active vs. inactive). Indications for surgical removal include macroadenomas causing compression of neighboring structures and endocrine-active adenomas that cause detrimental systemic effects, as seen in acromegaly and Cushing’s disease. The majority of pituitary tumors can be safely and effectively removed through an endonasal, transsphenoidal route. Historically, this procedure has been performed under microscopic visualization; however, the recent emergence and evolution of endoscopic techniques have gained acceptance among skull base surgeons managing these lesions. The endoscope may be used as the sole source of visualization or as an adjunct in the microscopic approach. Its increased luminosity and angled profile grants the surgeon the possibility of visualization of lateral and posterior components of the sellar compartment, a feature particularly useful in macroadenomas invading the cavernous sinuses. In this chapter we describe the surgical technique, indications and complication avoidance strategies of the microscopic, endoscope-assisted transsphenoidal removal of pituitary adenomas.
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Filho, L.F.S.D. et al. (2014). Pituitary Adenomas: Treatment Using the Endonasal Approach. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 12. Tumors of the Central Nervous System, vol 12. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7217-5_18
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DOI: https://doi.org/10.1007/978-94-007-7217-5_18
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