Surgery of Pituitary Tumours

Abstract

There exist many different types of tumours that originate from the pituitary gland and the surrounding structures of the sella turcica. The most common of these tumours include pituitary adenomas and craniopharyngiomas. Pituitary tumours can cause symptoms secondary to mass effect or clinical syndromes, such as in Cushing’s disease and acromegaly, from excess hormone production. Surgical resection of pituitary tumours is generally the first-line treatment. There are two groups of surgical approaches, transcranial and endonasal, with the endoscopic transsphenoidal route rapidly becoming the standard. Surgical resection is highly successful for relief of symptoms caused by mass effect. Resection of functioning adenomas can be more challenging, but remission rates of these syndromes after surgery are high. Although the complications from these operations can be serious, they occur infrequently. The most prevalent complication associated with transsphenoidal surgery is postoperative cerebrospinal fluid leak; however, advances in surgical technique have significantly reduced its incidence. Significant and continued surgical experience improves outcomes and decreases complication.