Pituitary surgery

Pituitary surgery remains the procedure of choice for dealing with a majori ty of clinically encountered pituitary adenomas. This article discusses the indications for surgical management of the various types of pituitary tumo rs, emphasizing the use of the transsphenoidal approach, which is suitable fur more than 90% of pituitary tumors. The results for each type of hyperse creting tumor are given, with remission rates ranging from 60% to 90%, depe nding on the size and stage of the tumor, and the type of endocrinopathy in volved. For clinically nonfunctioning tumors, most of which present with he adache and visual loss, improvement or maintenance of vision occurs in 87% of patients. Complications of pituitary surgery are relatively rare, with a mortality rate less than 1% and a morbidity rate less than 3% for most les ions currently encountered. Modern techniques and improvements, both in end ocrine diagnosis and surgical management, should lead to even more effectiv e therapy in the future.