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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Transcranial surgery for pituitary adenomas.
Michael Buchfelder1, Juergen Kreutzer
1Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany. michael.buchfelder@uk-erlangen.de
Pituitary
|April 19, 2008
Summary
Transcranial surgery for pituitary adenomas is reserved for complex cases extending beyond the sella. While transsphenoidal approaches are standard, transcranial routes offer solutions for specific tumor extensions, despite higher risks.
Area of Science:
- Neurosurgery
- Endocrinology
Background:
- Transsphenoidal surgery is the predominant approach for pituitary adenomas.
- Transcranial approaches are necessary for tumors extending outside the sella turcica.
Purpose of the Study:
- To review current indications and limitations for transcranial surgery in pituitary adenoma management.
- To discuss preoperative workup, surgical techniques, outcomes, and complications of transcranial pituitary adenoma surgery.
Main Methods:
- Review of current literature on transcranial surgery for pituitary adenomas.
- Analysis of indications, surgical routes (pterional, subfrontal), and outcomes.
Main Results:
- Less than 10% of pituitary adenomas require craniotomies.
- Transcranial approaches are used for tumors with significant extrasellar extension.
- Transcranial surgery carries higher morbidity and mortality than transsphenoidal surgery, with a potential selection bias.
Conclusions:
- Transcranial surgery remains essential for select pituitary adenomas with extrasellar extension.
- Extended transsphenoidal techniques are expanding the applicability of the transsphenoidal approach.
- Careful patient selection and surgical technique are crucial for managing complex pituitary adenomas.
