Surgical approaches for pituitary tumors

Area of Science:

• Neurosurgery
• Endocrinology
• Surgical Oncology

Background:

• Pituitary surgery methods originated in the late 1890s.
• Historical techniques by Halsted, Cushing, and Hirsch remain foundational.
• The operating microscope spurred advancements in pituitary tumor resection.

Purpose of the Study:

• To review the historical development and current status of pituitary surgery techniques.
• To highlight the significance of transsphenoidal approaches for pituitary adenomas.

Main Methods:

• Review of historical surgical methodologies for pituitary access.
• Analysis of advancements including microsurgery and transsphenoidal techniques.
• Comparison of current popular transsphenoidal approaches.

Main Results:

• Surgical techniques have been refined since the late 19th century.
• Microsurgical advancements revitalized interest in transsphenoidal pituitary surgery.
• Sublabial and intranasal transseptal approaches are currently favored.

Conclusions:

• Transsphenoidal surgery is well-suited for small, intrasellar pituitary lesions.
• Prolactin-secreting microadenomas are effectively treated with these refined techniques.
• Modern pituitary surgery builds upon a long history of innovation.