Transsphenoidal and transcranial surgery for pituitary adenomas

Area of Science:

• Neurosurgery
• Endocrinology
• Surgical Oncology

Background:

• Pituitary surgery aims to remove tumors, preserve function, and correct hormonal imbalances.
• The transsphenoidal approach, pioneered over a century ago, is now the primary method for pituitary tumor resection.

Purpose of the Study:

• To review the historical development and advancements in pituitary surgery over the past century.
• To discuss contemporary surgical techniques, including microscopic and endoscopic approaches.
• To evaluate the role of stereotactic radiosurgery as an adjuvant therapy for complex pituitary adenomas.

Main Methods:

• Historical review of pituitary surgical techniques.
• Discussion of transsphenoidal, transcranial, microscopic, and endoscopic surgical approaches.
• Analysis of the integration of stereotactic radiosurgery (SRS) in pituitary tumor management.

Main Results:

• The transsphenoidal approach has evolved into the preferred method for most pituitary tumor surgeries.
• Microscopic and endoscopic techniques have refined tumor removal and functional preservation.
• Stereotactic radiosurgery is increasingly used for challenging adenomas, particularly those with cavernous sinus invasion.

Conclusions:

• Pituitary surgery has made substantial progress, enhancing tumor resection and patient outcomes.
• The evolution of transsphenoidal techniques, alongside adjuvant SRS, offers comprehensive management strategies for pituitary tumors.