Rebirth of an old modality: revisiting intraoperative ultrasound in pituitary surgery

Pituitary adenomas are prevalent intracranial tumors that, though benign, present surgical challenges due to their anatomy and hormonal behavior. Transsphenoidal surgery is the standard approach, but differentiation between normal gland and adenoma limits complete resection. Traditional imaging methods like MRI and CT are costly and disruptive, while intraoperative ultrasound (IOUS) offers a real-time, practical alternative for enhancing localization and surgical confidence. Recent advances in IOUS technology show promise, yet challenges such as spatial resolution and operator dependency hinder widespread use. This editorial discusses the potential of IOUS as a vital tool for improving safety and outcomes in pituitary adenoma surgeries.