Pituitary adenoma surgery: Difference between revisions

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{{CMG}} {{AE}} {{AAM}}
{{CMG}} {{AE}} {{AAM}}
==Overview==
==Overview==
The [[sphenoid bone|transsphenoidal]]  microsugrical approach is the mainstay of treatment for [[growth hormone]]-(GH) producing adenomas, [[adrenocorticotropic hormone]]-(ACTH) producing adenomas, and macroadenomas.
The [[sphenoid bone|transsphenoidal]]  microsugrical approach is the mainstay of treatment for [[growth hormone]]-(GH) producing adenomas, [[adrenocorticotropic hormone]]-([[ACTH]]) producing adenomas, and macroadenomas.


==Surgery==
==Surgery==
Surgical treatment for pituitary adenoma:<ref name=national cancer institute> Pituitary Tumor (2015) http://www.cancer.gov/types/pituitary/hp/pituitary-treatment-pdq#section/_13. Accessed on 9 28 2015 </ref>
[[Surgery|Surgical]] treatment for pituitary adenoma:<ref name="national" cancer="" institute=""> Pituitary Tumor (2015) http://www.cancer.gov/types/pituitary/hp/pituitary-treatment-pdq#section/_13. Accessed on 9 28 2015 </ref>
* Rapid deterioration of vision is considered as an immediate indication for surgery to relieve pressure produced by an expanding tumor mass.
* Rapid deterioration of [[vision]] is considered as an immediate indication for [[surgery]] to relieve pressure produced by an expanding [[tumor]] mass.
*The [[sphenoid bone|transsphenoidal]] microsurgical approach to a [[pituitary]] lesion is the most widely employed surgical approach to pituitary lesions and represents a major development in the safe surgical treatment of both hormonally active and nonfunctioning tumors.
*The [[sphenoid bone|transsphenoidal]] microsurgical approach to a [[pituitary]] lesion is the most widely employed surgical approach to [[Pituitary gland|pituitary]] lesions and represents a major development in the safe surgical treatment of both hormonally active and nonfunctioning [[tumors]].
*This approach is often successful in debulking tumors, even those that have a significant [[suprasellar]] extension (without hourglass-shape appearance).
*This approach is often successful in debulking [[tumors]], even those that have a significant [[suprasellar]] extension (without hourglass-shape appearance).


Contraindications to transsphenoidal microsurgical approach include:
[[Contraindications]] to transsphenoidal microsurgical approach include:
*Tumors with a significant suprasellar extension with an hourglass-shaped narrowing between the intrasellar and suprasellar component, blind attempts to reach the suprasellar tumor may lead to cerebral damage.
*[[Tumors]] with a significant [[Suprasellar tumors|suprasellar]] extension with an hourglass-shaped narrowing between the [[intrasellar]] and [[suprasellar]] component, blind attempts to reach the [[Suprasellar tumors|suprasellar tumor]] may lead to [[cerebral]] damage.
*An infection in the [[sphenoid sinus]]
*An infection in the [[sphenoid sinus]]


Craniotomies via a pterional or subfrontal approach may be performed if transsphenoidal microsurgical approach is contraindicated.
[[Craniotomy|Craniotomies]] via a pterional or subfrontal approach may be performed if transsphenoidal microsurgical approach is [[contraindicated]].


==References==
==References==

Latest revision as of 19:59, 2 October 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Overview

The transsphenoidal microsugrical approach is the mainstay of treatment for growth hormone-(GH) producing adenomas, adrenocorticotropic hormone-(ACTH) producing adenomas, and macroadenomas.

Surgery

Surgical treatment for pituitary adenoma:

  • Rapid deterioration of vision is considered as an immediate indication for surgery to relieve pressure produced by an expanding tumor mass.
  • The transsphenoidal microsurgical approach to a pituitary lesion is the most widely employed surgical approach to pituitary lesions and represents a major development in the safe surgical treatment of both hormonally active and nonfunctioning tumors.
  • This approach is often successful in debulking tumors, even those that have a significant suprasellar extension (without hourglass-shape appearance).

Contraindications to transsphenoidal microsurgical approach include:

Craniotomies via a pterional or subfrontal approach may be performed if transsphenoidal microsurgical approach is contraindicated.

References