There are two variants of access distinguished in surgical treatment of neoplasms of the pituitary gland and tumors of the parasellar region — transcranial and transnasal; sometimes these methods are used in combination. The method of approach to the tumor is determined individually in each case. Each of the methods can be performed using a microscope and/or an endoscope.
- The transcranial method is used in cases where a large part of the pituitary adenoma is located above the Turkish saddle (suprasellar) or with asymmetric growth of the nodes of the intracranial part of the tumor.
- Transnasal surgeries are indicated for tumors located in the Turkish saddle (endosellar), as well as for the spread of neoplasm in the sphenoid sinus (infrasellar).
Objectives of surgical treatment:
- Elimination of the threat to the patient’s life;
- Correction of endocrine and visual disorders;
- Removal of the tumor without expressed clinical manifestations, to prevent further deterioration of the condition;
Possible complications of surgical treatment:
- cerebral ischemic syndrome;
- meningitis;
- hemorrhage in the bed of a removed tumor;
- exacerbation of intercurrent diseases;
- nasal liquorrhea;
- transient visual impairments, hypopituitarism, diabetes insipidus, etc.