EVALUATION OF TRANSNASALTRANSSPHENOIDAL APPROACH FOR REMOVAL OF PITUITARY TUMORS

Abstract

Pituitary surgery can be performed through a variety of surgical approaches. These surgical approaches to pituitary adenomas have undergone a considerable refinement during the past century.

Transsphenoidal excision of pituitary adenomas utilizing the microsurgical techniques and the modern neuroradiological advances has become one of the major choices. In fact it's the procedure of choice for all microadenomas and most macroadenomas. Suprasellar extension is not a problem any more.

Advantages of Transsphenoida/ approach:

- For small tumors (intrasellar lesions):

o No need for manipulation or retraction of the brain.

o Total tumor removal with preservation and even improvement of pituitary function. - For Large tumors:

o Rapid decompression of optic pathways, cavernous sinus, hypothalamus or the brain itself in the sitting of low morbidity. o Lesions too large for resection by either transsphenoidal

or transcranial methods can be confirmed histologically by the transsphenoidal approach. - In poor risk patients, transsphenoidal approach can be used

for intentional subtotal tumor resection followed by radiotherapy. - Excellent cosmetic results and no loss of olfaction.