Journal of neuro-oncology
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Journal of neuro-oncology · Aug 2004
ReviewTranssphenoidal and transcranial surgery for pituitary adenomas.
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 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.
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The use of skull base techniques in the treatment of benign skull base tumors has allowed access to areas of the brain once considered inaccessible. The most common benign skull base tumors encountered in neurosurgical practice are benign meningiomas, schwannomas, and glomus jugulare tumors. Gross total resection of these lesions gives patients the best possible chance of a cure. In this paper, we review the rationale for the use of skull base surgery techniques for benign skull base tumors.