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Pituitary Adenoma: Diagnosis and Operative Considerations

Last Updated: September 28, 2018

Pituitary tumors were among the first tumors explored by the pioneer neurosurgeons. Their surgical history defines the history of our profession.

Figure 1: This patient was arguably one of Harvey Cushing’s most favorite patients. Cushing evaluated this patient in 1904 for acromegaly and operated on him through the transsphenoidal approach. The patient died immediately after his second operation. Near the turn of the century, transsphenoidal surgery literally placed Cushing on the brink of operating on the brain during the infancy of our specialty.

There are two main transsphenoidal approaches to expose pituitary tumors: endoscopic and microscope-assisted approaches. Transcranial approaches are exceedingly rarely necessary considering the reach of the endoscopic techniques. I have used...