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Transsphenoidal
and Transcranial Surgery for Pituitary Adenomas
William T. Couldwell
Department
of Neurosurgery, University of Utah School of Medicine, Suite 3B409,
30 North 1900 East, Salt Lake City, UT 84132-2303, USA; Tel.:
+1-801-581-6908; Fax: +1-801-581-4385; E-mail: william.couldwell@hsc.utah.edu
This
paper reviews the progress made over the first century of pituitary
surgery.
The goals of surgery for pituitary tumors are to eliminate tumor mass
effect and perform as complete a removal as possible, retain pituitary
function, and normalize any hormonal hypersecretion.
Since the initial transsphenoidal approach performed in Austria by
Schloffer, the transsphenoidal approach has become the preferred
surgical approach to most pituitary tumors.
The history and development of the transsphenoidal approach to the
sella is discussed, as are the contemporary techniques of microscopic
and endoscopic pituitary surgery.
The continued evolution of the variations and extension of the
transsphenoidal approach to other lesions are reviewed.
The indications and use of a transcranial approach to remove pituitary
tumors are discussed.
More recently, stereotactic radiosurgery (SRS) has become an important
adjuvant management technique in the management of difficult pituitary
adenomas, especially with cavernous sinus invasion.
Keywords: craniotomy,
endoscope, pituitary tumor, radiosurgery, transsphenoidal approach
Copyright
©
2004 Kluwer Academic Publishers.
All rights reserved
Source: http://ipsapp007.kluweronline.com/IPS/content/ext/x/J/5042/I/124/A/19/abstract.htm
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