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Updated: Jul 11, 2026
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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
[Pituitary adenomas invading the cavernous sinus. Transcranial transcavernous approach]
A Spallone1, J L Gonzàlez-Gonzàlez, F Mostes de Oca
1Neurological Centre of Latium, Roma, Italia.
Neurocirugia (Asturias, Spain)
|September 21, 2007
Summary
Transcranial surgery effectively removes cavernous sinus invading pituitary adenomas, achieving remission of symptoms and hormonal control. However, complications are frequent, with a risk of permanent neurological deficits.
Area of Science:
- Neurosurgery
- Endocrinology
- Oncology
Context:
- Pituitary adenomas are common intracranial tumors, often treated surgically.
- Cavernous sinus invasion presents challenges for standard transsphenoidal surgery, leading to incomplete tumor removal.
- A significant subset of pituitary adenomas (5-7%) invades critical parasellar structures.
Purpose:
- To evaluate the efficacy and outcomes of transcranial surgical removal for pituitary adenomas invading the cavernous sinus.
- To assess the feasibility of achieving complete tumor resection and symptom resolution in these complex cases.
Summary:
- A retrospective study analyzed 9 patients with pituitary adenomas invading the cavernous sinus who underwent transcranial surgery (fronto-orbitozigomatic craniotomy).
- Total or partial macroscopic removal was achieved in all cases, with improvement in hormonal levels and symptoms.
- Complications occurred in 6 patients, including one permanent neurological deficit (III cranial nerve paresis).
Impact:
- The transcranial transcavernous approach is effective for complete removal of intracavernous pituitary adenomas.
- This technique facilitates medium- to long-term remission of symptoms and hormonal control.
- While effective, the approach carries a notable risk of complications and potential permanent sequelae.
