Pituitary Carcinoma
Introduction Primary pituitary carcinomas are rare tumors defined as primary adenohypophyseal neoplasms that have undergone cerebrospinal or systemic metastasis. They constitute 0.1% to 0.2% of all pituitary tumors and their…
NEUROLOGY
Transsphenoidal Surgery for Acromegaly
Introduction Acromegaly is a medical condition defined by elevated serum growth hormone (GH) levels almost always secondary to hypersecretion by cells of the anterior pituitary. Descriptions of individuals consistent with…
The Neuro-Ophthalmology of Pituitary Tumors
Introduction The main purpose of this chapter is to provide a practical review of the visual and oculomotor manifestations of pituitary tumors. The close anatomical relationship between the pituitary gland…
Rhinological Evaluation
Introduction The approach to tumors of the pituitary gland has undergone a developmental evolution during the past century. While Sir Victor Horsley performed the first transcranial approach to the pituitary…
Microsurgical Approaches for Transsphenoidal Surgery
Introduction Modern transsphenoidal approaches began with the contributions of Jules Hardy, who built on the legacy of earlier transsphenoidal approaches from Cushing’s to Norman Dott to Gerard Guiot. Hardy introduced…
Complications: Avoidance and Management
Introduction Performing the transsphenoidal procedure requires the neurosurgeon to master a unique set of surgical techniques. While the ultimate goal rests with the hypophysis and neuraxis, the surgical approach mandates…
Transsphenoidal Surgery for Recurrent Disease
Introduction The transsphenoidal approach to pituitary tumors represents a fascinating chronicle in surgical history. The result of this evolution and continued refinement of the transsphenoidal approach is that pituitary tumors…
History of Transsphenoidal Surgery for Pituitary Tumors
Introduction Like many advances in medicine, the transsphenoidal procedure as we know it today is the result of a long, relentless process. Many bold and creative pioneer surgeons have contributed…
Principles and Pitfalls of Anesthesia for Transsphenoidal Surgery
Introduction Patients having transsphenoidal surgery offer many unique challenges to the anesthesiologist. Because of the prominent role of the pituitary gland in the endocrine system, patients require meticulous preoperative assessment,…
The Perioperative Care of the Pituitary Patient
Introduction The goals of definitive surgical treatment of pituitary lesions are the reversal of endocrinopathy and restoration of normal pituitary function; elimination of mass effect and restoration of normal neurological…
