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Updated: Apr 16, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Surgical management of Cushing's disease
Robert F Dallapiazza1, Edward H Oldfield, John A Jane
1Department of Neurosurgery, University of Virginia, PO Box 800212, Charlottesville, VA, 22908-0711, USA, rd4pm@virginia.edu.
Background:
Transsphenoidal selective adenomectomy is the first-line treatment for Cushing's disease. At experienced centers, early remission rates after transsphenoidal surgery range from 65 to 98%, however disease relapse frequently occurs with rates ranging from 2 to 35% at long-term follow up.
Methods:
This article discusses recently reported studies on the surgical outcomes from transsphenoidal surgery for Cushing's disease.
Conclusions:
One of the keys to a successful long-term surgical outcome is meticulous dissection using the adenoma's pseudocapsule as a surgical plane for complete resection. MRI-negative and invasive ACTH-secreting adenomas pose particular challenges for pituitary surgeons.
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