Transsphenoidal Approach For Pituitary Adenomas Microsurgery

Objectives: Transsphenoidal microsurgery has become a major approach for removal of pituitary adenomas. Due tO the anatomic differences of skullbase between Chinese and foreigners and the different experience of surgeons, the pre-and postoperation managements of the operation are different. This article summarizes our experience on 83 patients and discusses some relevant problems, including the diagnostic standards of adenoma size, surgeryindications, the apoplexy operation, the reoperation for recurrent cases, management of complications, postoperation radiotherapy, and the anatomy of sphenoidal sinus and sellar area, hoping to improve the successful rate of the operation.Method: 83 patients with different kinds of pituitary adenomas were operated by the direct transnasal transsphenoidal approach.Result: 38 tumors were excised totally. 32 tumors were excised subtotally. 13 tumors were excised partly. Cerebrospinal fluid rhinorrhea lay in eight patients. Eight patients suffered from diabetes insipidus.Conclusion:The direct transnasal transsphenoidal approach is an efective method that can shorten the operation time and reduce the morbidity of complications. It needs delicate operation implements and advanced equipments. For the pituitary adenomas invading into the cavernous sinus, the surgeons should have enough experience because they cann't see some part of the tumor. With the development of neuronavigation, endoscope, intraoperativemagnetic resonance and supersonic imaging, the operation will become more accurate and minimal invasive.Transsphenoidal microsurgery is a safe, simple, minimally invasive and efetive procedure for pituitary tunlors.